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目的 :探讨 MRI在喉癌颈部淋巴结转移术前诊断中的作用。方法 :对 1 9例 (2 4侧 )喉癌患者的颈部术前触诊、MRI扫描及颈清扫标本病理检查结果进行了对比研究。结果 :喉癌颈部转移淋巴结在 MRI影像上基本呈圆形或类圆形 ,个别可表现为数个淋巴结的融合 ;MRI和临床触诊诊断颈部淋巴结转移的敏感率、特异率和准确率分别为 85.7%、90 .0 %、87.5%和 64.3%、70 .0 %、66.7% ,MRI诊断的准确率明显高于临床触诊 ;同时颈部转移淋巴结除了在形态、大小方面发生改变外 ,转移淋巴结内部的 MRI信号及其周围邻近的软组织结构也有明显改变 ,其在 T1加权像上表现为略低信号和等信号的混合 ,T2 加权像表现为高信号 ,转移淋巴结轮廓清晰 ,周围可出现不完全环状脂肪增生带。使用脂肪抑制和 Gd- DTPA增强扫描的 T1加权像能较好地显示较小的转移淋巴结。结论 :MRI较为客观、直接 ,有助于颈部淋巴结转移的早期发现 ,提高诊断的准确率。
Objective: To explore the role of MRI in the preoperative diagnosis of laryngeal cancer with lymph node metastasis. METHODS: A comparative study of preoperative palpation, MRI scans, and pathological examinations of cervical dissection specimens was performed in 19 cases of patients with laryngeal carcinoma. RESULTS: The metastatic cervical lymph nodes of laryngeal squamous cell carcinomas were basically round or round on MRI images. Some of them could be expressed as the fusion of several lymph nodes. The sensitivity, specificity, and accuracy of MRI and clinical palpation for the diagnosis of cervical lymph node metastasis were respectively. For 85.7%, 90.0 %, 87.5% and 64.3%, 70.0 %, 66.7%, the accuracy of MRI diagnosis was significantly higher than that of clinical palpation; meanwhile, the lymph node metastasis of neck was changed in shape and size. The MRI signal inside the metastatic lymph nodes and its surrounding soft tissue structure also showed significant changes. The T1-weighted images showed a mixture of slightly lower signals and equal signals. The T2-weighted images showed high signals. The metastatic lymph nodes had clear outlines and appeared around. Incomplete cyclic lipoid hyperplasia. T1-weighted images using fat suppression and Gd-DTPA enhanced scans can better show smaller metastatic lymph nodes. Conclusion: MRI is more objective and direct, and it is helpful for the early detection of cervical lymph node metastasis and improves the accuracy of diagnosis.