甲状腺癌术后声带麻痹CT诊断.docVIP

甲状腺癌术后声带麻痹CT诊断 　　[摘 要] 目的：分析甲状腺癌术后声带麻痹的CT表现及其与颈部淋巴结转移和局部复发的关系，评价CT的诊断价值。方法：回顾性分析临床诊断为甲状腺癌术后声带麻痹的34例患者的CT资料。结果：声带麻痹CT表现为：患侧梨状窝扩大32例 （94.1%）；患侧杓会厌皱襞增厚、向内侧移位32例 （94.1%）；患侧喉室扩大30例（88.2%）；患侧杓状软骨向前内侧移位19例（55.9%）；患侧声带萎缩外展8例（23.5%）；患侧声带固定于旁正中位6例（17.6%）。其中前三个表现最可靠。同时，10例（29.4%）患者发现颈部淋巴结转移，5例（14.7%）患者发现肿瘤局部复发。结论：CT能够诊断甲状腺癌术后声带麻痹，而且有助于明确引起声带麻痹的原因 [关键词] 声带麻痹；甲状腺癌；淋巴结转移；肿瘤复发；体层摄影术，X线计算机 中图分类号：R445 文献标识码：A 文章编号：2095-5200（2017）01-001-03 DOI：10.11876/mimt201701001 CT diagnosis of vocal cord paralysis after resection of thyroid carcinoma LI Hao，SHI Yan，WANG Yeqing，ZHAO Yong. （Department of Radiology，Xuzhou Cancer Hospital，Xuzhou 221005，China） [Abstract] Objective： To analyze the CT manifestations of vocal cord paralysis after resection of thyroid carcinoma and its relationship with cervical lymph node metastasis and local recurrence，and evaluate the value of CT diagnosis. Methods： CT images of 34 patients who had clinically diagnosed vocal cord paralysis after resection of thyroid carcinoma were retrospectively analyzed. Results： CT findings associated with vocal cord paralysis included： dilatation of the ipsilateral piriform sinus in 32 cases（94.1%）.Thickening and medial displacement of the ipsilateral aryepiglottic folds in 32 cases（94.1%）.Dilated ipsilateral laryngeal ventricle in 30 cases （88.2%）.Anterio-medial position of the ipsilateral arytenoid cartilage in 19 cases（55.9%）. Vocal cord atrophy and lateral displacement in 8 cases（23.5%）.Fixed cord in paramedian position in 6 cases（17.6%）. The first three findings are the most reliable in predicting the presence of vocal cord paralysis. Besides， cervical lymph node metastasis in 10 cases （29.4%） and local recurrence of thyroid carcinoma in 5 cases（14.7%） are found. Conclusion： CT is of diagnostic value for vocal cord paralysis after resection of thyroid carcinoma ， and is helpful for the clinician to identify a causative lesion on imaging. [Key words] Vocal cord paralysis； Thyroid carcinoma； Lymph node metastas