| Objective: The purpose of this study was to evaluate the clinical value ofultrasound in the diagnosis, type, classification, staging, and estimating cervicallymph node metastasis of laryngeal carcinoma.Methods: Fifty patients with hoarseness diagnosed by doctors ofotolaryngology department were detected by ultrasonography (USG) andcomputed tomography (CT) blindly. The location, size, number, extent, edge,shape, internal echo, and features of color Doppler flow imaging (CDFI) andpulsed wave Doppler (PW) of laryngeal affection were observed. The relation oflaryngeal affection with adjacent tissue and structure was also observed and thestatus of cervical lymph node was viewed as well. The motion of the vocal cordwas observed while patients made eupnea and Valsalva's maneuver, and thevibration of the vocal cord was observed while patients pronounced "Yi". Thefindings of ultrasonography and CT were compared with the pathological results ofoperation or/and biopsy in the laryngeal endoscope examination. Sonographicappearances of laryngeal carcinoma were obtained. We also got much informationabout laryngeal carcinoma in ultrasonography and CT, such as sensitivity,specificity, accuracy of diagnosis, classification and T-staging between the twoexaminations and cervical lymph node metastasis. The detection rate of thelaryngeal affection in ultrasonography and CT was calculated as well. Then wedealt with the data with statistical analysis by using software package of SPSS 11.5for Windows. At the same time, 30 normal volunteers were detected byultrasonography as well and the normal sonographic appearances of larynx wereobtained.Results: Study in 30 cases of normal laryngeal ultrasonograhpy indicated thatultrasound could reveal the normal anatomic structure of laryngx clearly. In 50patients with hoarseness, 38 cases were diagnosed as laryngeal carcinoma bypathology, and 12 cases as nonlaryngocarcinoma (3 cases of hypopharyngealcarcinoma, 3 cases of polyp, 2 cases of cyst, 2 cases of papillary hyperplasia, 1case of atypical hyperplasia, and 1 case of angiocavernoma). In 38 cases oflaryngeal carcinoma, 37 true positive results and 1 false negative result werediagnosed by USG, and 33 true positive results and 5 false negative results werediagnosed by CT; in 12 cases of nonlaryngocarcinoma, 11 true negative results and1 false positive result were diagnosed by USG, and 10 true negative results and 2false positive results were diagnosed by CT. These showed that the sensitivity fordiagnosing laryngeal carcinoma at USG was 97.4% (37/38), the specificity 91.7%(11/12), and the accuracy 96.0% (48/50), and that the sensitivity for diagnosis atCT was 86.8% (33/38), the specificity 83.3% (10/12), and the accuracy 86.0%(43/50). The accuracy for the type of laryngeal carcinoma at USG was 94.7%(36/38), and the accuracy for the T-staging 84.2% (32/38). The accuracy for thetype of laryngeal carcinoma at CT was 78.9% (30/38), and the accuracy for theT-staging 65.8% (25/38). Accuracies for estimating cervical lymph node metastasisfrom laryngeal carcinoma at USG and CT were both 93.8% (15/16). Comparisonin the detection rate of laryngeal disease between USG and CT (P = 0.031, P <0.05) showed that there was a significant difference in the detection rate oflaryngeal disease between the two ways.Conclusions: 1. USG can show the location, size, number, appearance,internal echo, and blood supply of laryngeal carcinoma accurately. 2. USG canevaluate invasion extent of laryngeal carcinoma accurately, especially it canevaluate whether or not the thyroid cartilage is invaded, which is superior to CT. 3.USG can estimate the cervical lymph node metastasis from laryngeal carcinomaaccurately and provide available information for clinical diagnosis. 4. USG canhelp to identify the TNM staging of laryngeal carcinoma and provide importantevidence for clinical management.
|
PDF Full Text Request