【摘要】 目的探讨螺旋ＣＴ在喉及下咽部的临床应用价值。方法喉及下咽癌５７例，１９例螺旋ＣＴ扫描与３８例传统ＣＴ扫描行对比分析，８例多平面重建图像与轴位图像对比；８例（另有４例正常喉及１例声带息肉）螺旋ＣＴ扫描后经软件处理行仿真内窥镜成像，并与纤维喉镜对照研究。结果⑴１９例螺旋ＣＴ轴位图像在显示粘膜表面病变，估计深部浸润范围，喉软骨破坏，以及颈部淋巴结方面均与手术所见相符；而３８例普通ＣＴ中有３例对侧声带表面病变、１例喉软骨破坏及１例颈部淋巴结转移漏诊。⑵８例螺旋ＣＴ多平面重建中７例从不同角度、不同方位显示了喉内解剖、肿瘤及其浸润范围及血管、气道的情况。⑶４例正常喉、１例双侧声带息肉及８例喉癌ＣＴ仿真内窥镜从头端入路显示喉内解剖及病变位置、形态、大小范围与纤维喉镜所见一致，且２例从足端入路显示了纤维喉镜不能显示的声门下及气道狭窄远端情况。结论螺旋ＣＴ较传统ＣＴ敏感度及准确率高；多平面重建可更好地显示喉室、颈部血管及气道情况，是轴位图像的很好补充；ＣＴ仿真内窥镜成像可以分别从头端或从足端入路显示喉腔结构，是纤维喉镜的补充手段更多还原

【Abstract】 Purpose To evaluate the clinical application of helical CT in larynx and hypopharynx. Methods 19 patients with cancer of larynx or hypopharynx scanned by helical CT were studied and compared with 38 cases studied by conventional CT. The virtual endoscopy images were compared with fiberoptic laryngoscopy in 13 patients. Results (1) All lesions of 19 patients shown on helical CT axial images were proved by operation, whereas three mucosal lesions , one cartilage invasion and one lymphadenopathy were missed by conventional CT. (2)Multiplanar images in 7 cases displayed clearly the laryngeal structure,the vessels and airway from multiple views.(3) CT virtual endoscopy demonstrated the mucosal structure and mucosal lesions craniocaudally just like the fiberoptic laryngoscopy. However CT endoscopy demonstrated the lesion of subglottic region and airway by caudocranial approach not accessible to fiberoptic laryngoscopy. Conclusion Both sensitivity and accuracy of helical CT in diagnosing cancers of larynx and hypopharynx are superior to conventional CT. The multiplanar capability of helical CT is better than axial view in observation of the ventricle,vessels and airway. CT virtual endoscopy can display the mucosal surface structures of larynx, either from above or from below. It is a good complementary technique to fiberoptic laryngoscopy.更多还原