CAJ | 학술논문

目的：探讨MRI在喉癌颈部淋巴结转移术前诊断中的作用。方法：对19例(24侧)喉癌患者的颈部术前触诊、MRI扫描及颈清扫标本病理检查结果进行了对比研究。结果：喉癌颈部转移淋巴结在MRI影像上基本呈圆形或类圆形，个别可表现为数个淋巴结的融合；MRI和临床触诊诊断颈部淋巴结转移的敏感率、特异率和准确率分别为85．7％、90．0％、87．5％和64．3％、70．0％、66．7％，MRI诊断的准确率明显高于临床触诊；同时颈部转移淋巴结除了在形态、大小方面发生改变外，转移淋巴结内部的MRI信号及其周围邻近的软组织结构也有明显改变，其在T1加权像上表现为略低信号和等信号的混合，T2加权像表现为高信号，转移淋巴结轮廓清晰，周围可出现不完全环状脂肪增生带。使用脂肪抑制和Gd-DTPA增强扫描的T1加权像能较好地显示较小的转移淋巴结。结论：MRI较为客观、直接，有助于颈部淋巴结转移的早期发现，提高诊断的准确率。
목적：탐토MRI재후암경부림파결전이술전진단중적작용。방법：대19례(24측)후암환자적경부술전촉진、MRI소묘급경청소표본병리검사결과진행료대비연구。결과：후암경부전이림파결재MRI영상상기본정원형혹류원형，개별가표현위수개림파결적융합；MRI화림상촉진진단경부림파결전이적민감솔、특이솔화준학솔분별위85．7％、90．0％、87．5％화64．3％、70．0％、66．7％，MRI진단적준학솔명현고우림상촉진；동시경부전이림파결제료재형태、대소방면발생개변외，전이림파결내부적MRI신호급기주위린근적연조직결구야유명현개변，기재T1가권상상표현위략저신호화등신호적혼합，T2가권상표현위고신호，전이림파결륜곽청석，주위가출현불완전배상지방증생대。사용지방억제화Gd-DTPA증강소묘적T1가권상능교호지현시교소적전이림파결。결론：MRI교위객관、직접，유조우경부림파결전이적조기발현，제고진단적준학솔。
Objective:To assess the potential or limitation of MRI for demontrating the pathological cervicallymphnodes. Method :A prospective diagnostic study on cervical lymphnode metastasis from laryngeal carcinomawas performed for 19 cases undergone neck dissection (5 cases undergone bilateral neck dissection, 24 specimensof neck dissection were collected in total). With pathological findings as the criterion, sensitivity and specificityand accuracy were calculated for palpation and MRI examination of all patients. Result:MRI had obviously highersensitivity specificity and accuracy than palpation. Besides the changes in size and shape of the metastaticlymphnodes, the intensity of MRI inside the metastic lymphnodes was showed as mixed hypo-isointensity inT1WI and hyper intensity in T2WI. Conclusion:MRI examination was accurate in detecting cervical lymphnodemetastasis and could image occult lymphnodes which are inaccessible on palpation. Thus, MRI will probably playan important role in the evaluation of malignant lymphnode metastasis.