Accuracy of magnetic resonance imaging in predicting absence of fixation of head and neck cancer to the prevertebral space
Accuracy of magnetic resonance imaging in predicting absence of fixation of head and neck cancer to the prevertebral space
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DOI：
10.1002/hed.20128
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发表时间：
2005-02-01
影响因子：
2.9
通讯作者：
Chalian, AA
中科院分区：
文献类型：
--
作者：
Hsu, WC;Loevner, LA;Chalian, AA
背景本研究的目的是确定术前保留咽后脂肪平面的磁共振（MR）图像在预测头颈部癌的固定或扩展到椎前间隙的情况下的准确性。回顾性分析了在我们头颈部癌症中心接受治疗的75例T3或T4原发性咽或喉癌患者的MR图像。由两名头颈部放射科医师独立盲法评价MRI图像，以保留肿瘤与椎前肌肉组织之间的咽后达特。在保留脂肪的病例中，评估椎前肌肉复合体是否存在T2高信号和增强。所有患者均接受了全内镜、手术或两者联合治疗。75例患者中有40例在T1加权像上保留了肿瘤和椎前间隙之间的咽后脂肪平面。在所有40例病例中，椎前肌在T2加权和增强MRI上表现正常。40例中39例肿瘤与椎前筋膜无固定，可手术切除。在晚期头颈部癌患者中，在非增强T1加权像上肿瘤和椎前肌肉组织之间的脂肪保留可靠地预测椎前间隙固定的缺乏。(C)2004 Wiley Periodicals，Inc.头颈27：95-100，2005
Background. The purpose of this study was to determine the preoperative accuracy of preservation of the retropharyngeal fat plane on magnetic resonance (MR) images in predicting the absence of fixation or extension of head and neck carcinomas to the prevertebral space.Methods. The MR images of 75 patients with T3 or T4 primary pharyngeal or laryngeal cancers seen over a 5-year period and treated at our Head and Neck Cancer Center were retrospectively reviewed. The MR images were independently and blindly evaluated by two head and neck radiologists for preservation of the retropharyngeal tat plane between the tumor and prevertebral musculature. In cases in which the fat was preserved, the prevertebral muscle complex was assessed for the presence of T2 hyperintensity and enhancement. All patients underwent pan-endoscopy, surgery, or both.Results. Forty of 75 patients had preservation of the retropharyngeal fat plane between the tumor and the prevertebral compartment on T1-weighted images. In all 40 cases, the prevertebral muscles had a normal appearance on T2-weighted and enhanced MR images. Intraoperative assessment revealed absence of fixation of tumor to the prevertebral fascia in 39 of 40 cases, and these tumors were resectable.Conclusion. In patients with advanced head and neck carcinomas, preservation of the fat between the tumor and the prevertebral musculature on unenhanced T1-weighted images reliably predicts absence of prevertebral space fixation. (C) 2004 Wiley Periodicals, Inc. Head Neck 27: 95-100, 2005