Neoplastic invasion of the laryngeal cartilage: comparison of MR imaging and CT with histopathologic correlation.
OBJECTIVE
To compare the usefulness of computed tomography (CT) and gadolinium-enhanced magnetic resonance (MR) imaging in the detection of neoplastic invasion of laryngeal cartilage.


METHODS
In a prospective study, 53 patients with carcinoma of the larynx or piriform sinus underwent CT and MR imaging before total or partial laryngectomy. The findings at imaging and pathologic examination were compared.


RESULTS
At histologic examination, neoplastic invasion of cartilage was present in 34 patients and absent in 19. MR imaging was more sensitive than CT (89% vs 66%; P = .001). Inflammatory changes and fibrosis, however, were indistinguishable from tumor on MR images, resulting in overestimation of neoplastic invasion in a large number of patients. Therefore, MR imaging was less specific than CT (84% vs 94%; P = .004).


CONCLUSIONS
MR imaging is more sensitive than CT in detecting neoplastic invasion of cartilage, but the inability to differentiate between nonneoplastic inflammatory changes and tumor with MR imaging leads to overestimation of neoplastic invasion.
Becker
M
M
Department of Diagnostic Radiology, University of Bern, Inselspital, Switzerland.
Zbären
P
P
Laeng
H
H
Stoupis
C
C
Porcellini
B
B
Vock
P
P
D002294:Carcinoma, Squamous Cell / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D003287:Contrast Media; D004338:Drug Combinations; D005069:Evaluation Studies as Topic; D005189:False Positive Reactions; D005260:Female; D019786:Gadolinium DTPA; D006801:Humans; D007817:Laryngeal Cartilages / Q000000981:diagnostic imaging / Q000473:pathology*; D007822:Laryngeal Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D007825:Laryngectomy; D008279:Magnetic Resonance Imaging; D008297:Male; D008536:Meglumine; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009942:Organometallic Compounds; D004369:Pentetic Acid / Q000031:analogs & derivatives; D010610:Pharyngeal Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed
D003287:Contrast Media; D004338:Drug Combinations; D009942:Organometallic Compounds; D008536:Meglumine; D004369:Pentetic Acid; D019786:Gadolinium DTPA