COMPLEX ROLE OF MULTIDETECTOR COMPUTED TOMOGRAPHY IN DIAGNOSTICS OF LOCAL RECURRENCES OF LARYNX CANCER AFTER RADICAL TREATMENT
Keywords:
laryngeal cancer, local recurrences, radical treatment, computed tomography, recurrences detection.Abstract
Summary. Cancer of the larynx — oncological pathology
that is characterized by high mortality. Recurrence after
treatment of laryngeal cancer develops in 15–50% cases. There are some difficulties by early detection of local
recurrence of laryngeal cancer. Aim: to identify signs of
local recurrence of laryngeal cancer according to a complex multidetector computed tomography (MDCT). Objects and methods: the study involved 124 patients after laryngectomy, the local recurrence of laryngeal cancer was diagnosed in 53 (42.7%) patients. Results: in
53 patients the main signs of local recurrence of laryngeal cancer were established: the size of tumor 1–2 cm
(24 patients, 45.3%); extralaryngeal localization of tumor (27 patients, 51.0%), especially in parapharyngeal (16 patients, 30.2%), carotid spaces (9 patients,
17.0%); heterogeneous enchancement of contrast agent
(39 patients, 73.6%); invasion of surrounding organs,
the structures of the neck (44 patients, 83.0%). Additional MDCT-signs of local recurrence were identified,
according to the MDCT-angiography, MDCT-perfusiography — respectively, qualitative and quantitative
characteristics of tumor blood flow. Сonclusion: for the
first time in Ukraine the quantitative parameters of tumors’ blood flow of local recurrences of laryngeal cancer
were established. The significant difference was between
bloodflow (BF) and mean trasit time (TT) between intact, infiltrative soft tissues and tumor. For tumor BF,
MT were 42–68 ml/100 g/min and 2.2–6.1 s, for soft
tissues with oedema (peritumoral or postradiation) BF,
MT were 32–42 ml/100 g/min and 6.1–7.9 s, for intact soft tissues BF, MT were ≤ 32.0 ml/100 g/min and
≥ 7.9 s. It allowed to establish the limits of the tumor,
and therefore to plan further treatment of such patients.
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