[Spiral CT of the head-neck area: the advantages of the early arterial phase in the detection of squamous-cell carcinomas].
OBJECTIVE
To determine if scanning in the arterial phase improves detection of squamous cell carcinomas in the pharynx and larynx.


METHODS
In a prospective clinical study 20 patients with a pharyngeal or laryngeal carcinoma were examined with by spiral CT. 80 ml lopromid were intravenously injected as a bolus with a rate of 3 ml/sec. Two consecutive spiral CT scans were performed with start-delay times of 20 and 70 seconds respectively. Delineation and contrast enhancement of tumours, cervical lymph nodes and vessels were evaluated. The radiodensities (HU) of tumors, lymph nodes vessels, pharyngeal wall and muscle were measured.


RESULTS
Comparing early and late start delay time scans tumor assessment in the early phase was better in 58%, less in 16% and equal in both scans in 26%. 82% of the pathologic lymph nodes had more peripheral enhancement than surrounding muscle tissue. During the arterial phase the measured radiodensities of the common carotid artery and jugular vein were significantly higher than in the second phase.


CONCLUSIONS
Contrast-enhanced special CT permits accurate morphologic assessment (size, infiltration) of pharyngeal and supraglottic laryngeal squamous cell carcinoma, while pathologic lymph nodes already have a sufficient contrast enhancement for the detection.
Conrad
R
R
Radiologische Universitätsklinik Bonn. R.Conrad@t-online.de
Pauleit
D
D
Layer
G
G
Kandyba
J
J
Kohlbecher
R
R
Hortling
N
N
Baselides
P
P
Schild
H
H
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000000981:diagnostic imaging*; D003287:Contrast Media; D006257:Head / Q000000981:diagnostic imaging; D006258:Head and Neck Neoplasms / Q000000981:diagnostic imaging*; D006801:Humans; D007472:Iohexol / Q000031:analogs & derivatives; D008875:Middle Aged; D015999:Multivariate Analysis; D009333:Neck / Q000000981:diagnostic imaging; D011446:Prospective Studies; D013997:Time Factors; D014057:Tomography, X-Ray Computed / Q000379:methods* / Q000706:statistics & numerical data
D003287:Contrast Media; D007472:Iohexol; C038192:iopromide