Predictive indicators for thyroid cartilage involvement in carcinoma of the larynx seen on spiral computed tomography scans
Predictive indicators for thyroid cartilage involvement in carcinoma of the larynx seen on spiral computed tomography scans
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螺旋计算机断层扫描显示的喉癌甲状软骨受累的预测指标
DOI：
10.1017/s0022215106001939
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发表时间：
2006
影响因子：
1.7
通讯作者：
M. Kumar
中科院分区：
文献类型：
--
作者：
R. Fernandes;P. Gopalan;C. Spyridakou;G. Joseph;M. Kumar
目的：最近的研究表明，螺旋CT扫描是预测肿瘤侵袭甲状软骨的一种敏感的影像方法。本研究的目的是：评估术前螺旋CT预测喉癌患者甲状软骨受累的准确性；并阐明准确显示软骨受累的因素。材料和方法：回顾了在南威尔士两家大医院接受喉切除术的27例患者的病历，包括螺旋CT扫描和病理报告。一位对横断面成像特别感兴趣的放射科顾问根据明确、客观的标准，重新评估了扫描结果，以评估肿瘤对甲状软骨的侵犯。这些标准包括：软组织不对称；髓间隙丧失；表面尖刺或不规则；软骨框架变形；以及软骨两侧的异常软组织。然后将放射学发现与肿瘤侵犯软骨的组织病理学证据相关联。结果：27例中15例有甲状软骨组织学侵犯。预测甲状软骨受累的最具特异性的标准是两侧软骨是否有肿瘤(特异性为91%，敏感性为66%)。两种标准相结合，敏感性和特异性分别提高到86%和91%。
Objectives: Recent studies have shown that the spiral computed tomography (CT) scan is a sensitive imaging modality for predicting neoplastic invasion of thyroid cartilage. The objectives of our study were: to assess the accuracy of pre-operative spiral CT in predicting thyroid cartilage involvement in patients with carcinoma of the larynx; and to elucidate the factors that would accurately indicate cartilage involvement. Material and methods: Medical records, including spiral CT scans and pathological reports, were reviewed for 27 patients who had undergone laryngectomy in two major hospitals in south Wales. A consultant radiologist with special interest in cross-sectional imaging re-evaluated the scans to assess neoplastic involvement of the thyroid cartilage, based on definite, objective criteria. These criteria included: soft tissue asymmetry; loss of medullary space; spiky or irregular surface; distortion of cartilage framework; and abnormal soft tissue on both sides of the cartilage. The radiological findings were then correlated with the histopathological evidence of cartilage invasion by the tumour. Results: Out of the 27 cases, 15 had evidence of histological invasion of thyroid cartilage. The most specific criterion to predict thyroid cartilage involvement was the presence of tumour on both sides of the cartilage (specificity of 91 per cent, sensitivity of 66 per cent). Combining two criteria increased both the sensitivity and the specificity to 86 and 91 per cent, respectively.