CT, MRI & US IN STAGING CERVICAL METASTASES

该项目的目标是确定计算机的相对角色 体层摄影术(CT)、核磁共振成像(MRI)和超声检查 颈部和咽后转移性疾病的评价。在病人中 上呼吸道鳞状细胞癌的存在 宫颈转移的程度与宫颈转移的程度一样重要 原发灶范围在决定治疗和预后中的作用。有时， 颈部病变量是影响预后的主要因素。几个功能 颈部疾病在治疗计划中具有最重要的意义，包括： (1)颈部是正数还是负数，(2)阳性结节数和 累及颈部的水平，(3)肉眼可见的囊膜穿透 以及扩散到结周软组织的程度，包括 颈动脉或颈深肌固定；(4) 咽后、咽旁和气管食管沟受累 节点。 CT已证明有能力提供上述所有数据；然而，公司 其中一些用途的诊断标准和可靠性仍然没有 已经成立了。核磁共振已被认为是CT的替代或补充 在颈部疾病的分期方面，但关于这一主题的数据很少。 超声波是一个有用的辅助工具，但不是一个权威的研究；它的特殊性 角色尚未确定。 在这项研究中，最先进的CT、MRI和超声波将在 上呼吸道鳞状细胞癌患者。 考试将在不知情的情况下进行和解释 物理发现。节点将映射到每个节点的匹配逻辑示意图上 影像方式和由每位临床医生负责的患者。相同 地图将根据手术结果绘制，最后是病理 颈部标本的检查。地图将记录所有关键因素 上面概述了。对这些数据的比较应该确定可靠性 对于每个重要变量的每项研究，以及最终适当的 在评估颈部疾病时，每次检查的位置。这将反过来， 对初诊影像检查选择的影响 肿瘤部位。许多头颈部癌症需要在检查前进行检查。 治疗；适当的研究排序将避免错误并控制成本。 在头颈部癌症的治疗中需要这样精确的数据来控制 疾病，同时保存外观和功能。

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.