摘要:目的探讨螺旋CT多平面重组 (MPR)、三维重建 (3D) 和仿真喉镜 (CTVL) 在喉及下咽癌的临床应用价值。方法 24例喉及下咽癌患者进行轴位螺旋CT扫描,同时做MPR、3D和CTVL成像,并与纤维喉镜和手术所见进行对照分析。结果螺旋CT轴位结合MPR图像对术前肿瘤分期和诊断颈部淋巴结转移的准确性均为96%;25%的患者MPR显示肿瘤侵犯的范围优于轴位,3D重建可立体显示肿瘤的侵犯范围及其与血管、气管的关系;头端CTVL显示的喉及下咽部腔内肿瘤的部位、大小及侵犯范围与纤维喉镜所见相似,4例从足侧观察肿瘤与声带和前联合的关系弥补了纤维喉镜的不足。结论螺旋CT轴位结合MPR、3D和CTVL图像可以更完整地提供喉及下咽癌的全面资料。%Objective To evaluate the clinical applications of helical CT multiplanar reformation (MPR), three -dimensional reconstruction (3D) and virtual laryngoscopy (CTVL) in laryngeal and hypopharyngeal carcinoma.Methods Axial helical CT scan was performed in 24 patients with laryngeal or hypopharyngeal carcinoma, meanwhile MPR, 3D and CTVL were performed on each patient. The results were compared with the fiberoptic laryngoscopic and surgical findings.Results Axial helical CT combined with MPR images, the accuracy of preoperative tumor staging and detection of metastatic lymph nodes were both 96%. In 25% of the cases, MPR was more informative than axial images about the extent of tumor invasion. The 3D image three-dimensionally displayed the extent of tumor invasion, and its relation to blood vessels and airway. On CTVL, the location, size and extent of intraluminal tumors of the larynx and hypopharynx when observed from above corresponded well with those observed under laryngoscope. In 4 patients, CTVL observed from below, demonstrated the relationship between the tumor and vocal cords and anterior commissure inaccessible to fiberoptic laryngoscopy.Conclusion Helical CT axial scanning combined with MPR, 3D and CTVL images, can provide more comprehensive information about laryngeal and hypopharyngeal carcinoma.