【摘要】 目的　研究高频超声内窥镜技术在喉病变 ,特别是喉癌诊断中的应用。方法　用可屈的小内径 (8～ 10F)高频 (10～ 2 0MHz)内窥镜式超声探头 ,对 45例患者行喉腔内无创伤检查。在探头频率 10MHz最大测及 3cm ,探头频率 2 0MHz最大测及 1.5cm ,超声图像上能准确测量出肿瘤垂直直径大小及位置。结果　其中检查出 3 2例喉癌 ,与周围组织相比 ,呈现出典型的反射矩阵波。在显微喉镜检查中 ,借助高频超声可扫查到T1声带癌 (13例 )、最小瘤体直径约 3mm的浸润癌。但 13例中有 6例探测不到肿瘤(假阴性 ) ,假阳性结果尚未发现。T2 ～T3 喉癌 (12例 )较易诊断 ,在声门上区和声门下区肿瘤较周围组织显示低回声区 ;T4 肿瘤 (7例 )侵犯甲状软骨 ,在超声图像肿瘤的低回声区与甲状软骨内膜的高回声区有明显的反差。另外测及喉良性病变 13例。结论　运用内窥镜式高频超声可在显微镜检查中对喉病变 ,特别是喉肿瘤的大小及相应浸润范围 ,作出更为准确的诊断 ,对保留喉功能的喉癌术式选择有指导意义更多还原

【Abstract】 Objective To study imaging technique of end olaryngeal high-frequency ultrasound for diagnosing laryngeal lesion, especially laryngeal cancer. Methods Fourty-five patients with laryngeal lesions were examined by small and flexible endolaryngeal high-frequency ultrasound transducer during microlaryngoscopy. The ultrasound frequencies were 10 MHz and 20 MHz, which can detect deep to 3 cm and 1.5 cm in laryngeal structure respectively. Site, size and depth of the laryngeal lesions were measured on sonography. Results Thirty-two cases with laryngeal carcinoma were scanned by endolaryngeal high-frequency ultrasound, which showed lower echogenicity compared to surrounding tissue. T 1 glottic carcinoma could be seen on sonography, but 6 out of 13 were hard to visualize (false negative). The smallest scanned (20 MHz) carcinoma had a size of 3 mm in diameter. T 2-3 carcinoma (12 cases) could be diagnosed without any difficulties. These tumors in the sub-and surpraglottic area showed a lower echogenicity than surrounding tissue. T 4 carcinoma (7 cases) were easy to diagnose because the low echogenic tumor perforated the thyroid cartilage, which was sharply demarcated by the bright echo of the inner perichondrium. Besides, 13 cases of benign laryngeal lesions were scanned by endolaryngeal high-frequency ultrasound. Conclusions Endolaryngeal high-frequency ultrasound can be performed to examine laryngeal lesion, especially for the size and infiltration of laryngeal carcinoma, and to make more accurate diagnosis during microlaryngoscopy, which is helpful in choosing surgical modality for conserving laryngeal function.更多还原