CT, MRI & US IN STAGING CERVICAL METASTASES

这个项目的目的是确定计算的相对作用， 断层扫描（CT），磁共振成像（MRI）和超声在 颈部和咽后转移性疾病的评估。 患者 上呼吸消化道鳞状细胞癌， 颈部转移性疾病的程度与 原发部位范围决定治疗和预后。 有时 颈部病变的体积是一个主要的预后因素。 若干特征 颈部疾病的治疗计划中最重要的是包括： (1)颈部是阳性还是阴性，（2）阳性节点的数量， 累及颈部的水平，（3）存在肉眼可见的包膜穿透 以及扩散到结周软组织的程度，包括 固定到颈动脉或深颈肌肉组织，和（4） 咽后、咽旁和气管食管沟受累 结 CT已经证明能够提供所有上述数据;然而，公司 其中一些用途的诊断标准和可靠性仍然没有 确立了习 MRI已被建议作为CT的替代或辅助 在颈部疾病的分期，但有关于这个问题的数据很少。 超声是一种有用的辅助手段，但不是一种确定性的研究;其特异性 角色尚未确定。 在本研究中，将对患者进行最先进的CT、MRI和超声检查。 上呼吸消化道鳞状细胞癌患者。 检查将在不了解 物理发现。 这些节点将映射到每个 成像模式和负责患者的每个临床医生。 相同的 将根据手术结果绘制地图，最后根据病理结果绘制地图。 检查颈部标本。 地图会记录所有关键因素 上面概述的。 这些数据的比较应建立可靠性 每项研究的每个重要变量，并最终适当的 在评估颈部疾病时，每次检查的位置。 反过来， 影响主要影像学检查的选择， 肿瘤部位。 许多头颈部癌症需要成像之前， 治疗;适当的研究顺序将避免错误并控制成本。 在治疗头颈癌时需要这样的精确数据，以控制 疾病，同时保持外观和功能。

The aim of this project is to determine the relative roles of computed tomography (CT), magnetic resonance imaging (MRI) and ultrasound in the evaluation of cervical and retropharyngeal metastatic disease. In patients with squamous cell carcinoma of the upper aerodigestive tract, the presence and extent of cervical metastatic disease is as important as that of the primary site extent in determining treatment and prognosis. Sometimes the volume of neck disease is a dominant prognostic factor. Several features of neck disease are of prime importance in treatment planning including: (1) is the neck positive or negative, (2) number of positive nodes and levels of neck involved, (3) presence of macroscopic capsular penetration and extent of spread to perinodal soft tissues, including likelihood of fixation to the carotid artery or deep neck musculature, and (4) involvement of retropharyngeal, parapharyngeal and tracheoesophageal groove nodes. CT has proven capable of providing all of the above data; however, firm diagnostic criteria and reliability for some of these uses are still not established. MRI has been suggested as a replacement for or adjunct to CT in staging neck disease, but there is little data available on the subject. Ultrasound is a useful adjunct but not a definitive study; its specific role is yet to be established. In this study state-of-the-art CT, MRI and ultrasound will be done on patients with squamous cell carcinoma of the upper aerodigestive tract. The examinations will be done and interpreted without knowledge of the physical findings. The nodes will be mapped on matching diagrams for each imaging modality and by each clinician in charge of the patients. The same map will be drawn based on surgical findings and finally the pathologic examination of the neck specimen. The maps will note all key factors outlined above. Comparison of these data should establish the reliability of each study for each variable of importance, and, ultimately the proper place for each examination in evaluating neck disease. This will, in turn, impact the choice of the primary imaging examination for studying various tumor sites. Many head and neck cancers require imaging prior to treatment; proper sequencing of studies will avoid error and contain costs. Such precise data is required in treating head and neck cancer to control disease while preserving appearance and function.