Abstract：Objective: To investigate the clinical value of spiral CT scan with oral contrast agent for displaying the anatomical structure of postcricoarytenoid region and piriform sinus region. Methods: The CT images of 60 patients after conventional spiral CT scan were reviewed and the CT images of 60 patients after spiral CT scan with oral contrast agent were analyzed. The anatomical structures of postcricoarytenoid region and piriform sinus region were observed. The demonstration rate was calculated and the image rating was evaluated by two radiologists and two otolaryngology doctors with a double-blind method. Chi-square test was adopted in statistical analysis. Results: In conventional spiral CT scan, the air occurrence rates were 65% and 70% in the right and left sinuses respectively. The detection rate of hypopharyngeal cavity was 43.3% in the arytenoid cartilage level and was 28.3% in the cricoid cartilage level. After orally contrasted spiral CT scanning, the left and right piriform sinus occurrence rates were 91.7%(55/60) and 90%(54/60). The detection rates of hypopharyngeal cavity in the arytenoid and cricoid cartilage level were 93.3%(56/60) and 96.7%(58/60) respectively. P<0.05 was considered statistically different. Conclusion: CT scans with oral contrast agent can contour the profile of hypopharynx and clearly display the anatomical structure of the postcricoarytenoid region and piriform sinus region in closed state. It can cover the shortage of clinical laryngoscope and provide objective images for detecting early diseases and confirming the surgical staging.
张继扬，万业达，张 琳，何 珍，刘竞艳，胡 鹏，何岸苇，蔡华琦，李 艳，刘立艳. 口服对比剂法CT检查显示下咽部解剖结构观察分析[J]. 中国临床医学影像杂志, 2016, 27(1): 6-9.
ZHANG Ji-yang, WAN Ye-da, ZHANG Lin, HE Zhen, LIU Jing-yan, HU Peng, HE An-wei,. Clinical values of CT scan with oral contrast agent for displaying the anatomical structure in hypopharynx. JOURNAL OF CHINA MEDICAL IMAGING, 2016, 27(1): 6-9.
[1]Schmalfuss IM. Imaging of the hypopharynx and cervical esophagus[J]. Neuroimag Clin N Am, 2004, 14(4): 647-662.
[2]Schmalfuss IM, Mancuso AA, Tart R. Postcricoid region and cervical esophagus: normal appearance at CT and MR imaging[J]. Radiology, 2000, 214(1): 237-246.
[3]SiddiquiI A, Connor SEJ. Imaging of the pharynx and Larynx[J]. Imaging, 2007, 19(1): 83-103.
[4]刘怀军译. 头颈影像学[M]. 2版. 北京：中国医药科技出版社，2011：735.
[5]王天铎. 喉科手术学[M]. 北京：人民卫生出版社，2000：12.
[6]Henrot P, Blum A, Toussaint B, et al. Dynamic manecuvers in local staging of head and neck malignancies with current imaging techniques: principles and clinical applications[J]. Radiographics, 2003, 23(5): 1202-1213.
[7]Lell MM, Greess H, Hothorn T, et al. Multiplanar functional imaging of the larynx and hypopharynx with multislice spiral CT[J]. Eur Radiol, 2004, 14(12): 2198-2205.
[8]李光存，张忻宇. 平静呼吸和改良Valsalva屏气下螺旋CT扫描在下咽癌诊断中的对比研究[D]. 青岛：青岛大学，2007.
2016, Vol. 27 
