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MRI is assuming a dominant role in imaging of the larynx. Its
superior soft tissue contrast resolution makes it ideal for
differentiating invasion of tumors of the larynx from normal or
more sharply circumscribed configuration of most of the benign
lesions. Over ten years ago CT made a major impact on laryngeal
examination because it was the first time that Radiologists were
beginning to look at submucosal disease. All of the previous
examinations duplicated the infor mation that was available to the
clinician via direct and in-direct laryngo scopy. With the advent
of rigid and flexible endoscopes, clinical examination became
sufficiently precise that there was little need to perform studies
such as laryngography which merely showed surface anatomy. The
status of deep structures by these techniques was implied based on
function. Fortunately laryngography is now behind us together with
all of the gagging and contrast reactions which we would all like
to forget. CT is still an excellent method of examining the larynx
but it is unfortunately limited to the axial plane. With presently
available CT techniques motion deteriorates any reformatting in
sagittal or coronal projections. The latter two planes are
extremely helpful in delineating the vertical extent of submucosal
spreads. MRI has proven extremely valuable by producing all three
basic projections, plus superior soft tissue contrast. Although
motion artifacts still degrade the images in some patients, newer
pulsing sequences that permit faster scanning are elimi nating most
of these problems."
1: General Aspects of Laryngeal Cancer.- 1. Introduction.- 1.1.
Incidence.- 1.2. Predisposing factors.- 2. TNM staging.- 2.1.
Introduction.- 2.2. Clinical classification.- 3. Diagnostic
aspects.- 3.1. History.- 3.2. External examination.- 3.3.
Laryngoscopy.- 4. Therapeutic options.- 4.1. Radiotherapeutic
options.- 4.1.1. Technique.- 4.1.2. Prognostic factors of
irradiation treatment.- 4.1.3. Complications due to radiation
therapy.- 4.2. Surgical options.- 4.2.1. Laser therapy and
microsurgical stripping.- 4.2.2. Laryngofissure and cordectomy.-
4.2.3. Vertical partial laryngectomy.- 4.2.4. Antero-frontal
laryngectomy for excision of the anterior commissure.- 4.2.5.
Supraglottic laryngectomy.- 4.2.6. (Wide-field) total
laryngectomy.- 4.3. Chemotherapeutic options.- 5. Therapeutic
management.- Tl- and T2-glottic carcinomas.- T1- and T2-subglottic
carcinomas.- T2- and T2-supraglottic carcinomas.- T3- and
T4-laryngeal cancer.- Nodal metastasis.- References.- 2: The
Patterns of Growth And Spread of Laryngeal Cancer.- 1.
Introduction.- 2. Spread of cancer in various regions.- 2.1. Cancer
of the supraglottic region.- 2.2. Cancer of the glottic region.-
2.3. Cancer of the subglottic region.- 3. Cartilage invasion.- 4.
Lymphatic spread.- 5. Vascular and perineural invasion.-
References.- 3: The Radiological Examination of the Larynx.- 1.
Introduction.- 2. Phonation manoeuvers.- 3. Frontal tomography.- 4.
Contrast laryngography.- 5. Computed tomography.- 6. CT versus
conventional radiological techniques.- 6.1. CT versus conventional
tomography.- 6.2. CT versus contrast laryngography.- References.-
4: General Aspects of MR Imaging.- 1. Introduction.- 2. Technical
principles.- 2.1. Properties of atomic nuclei.- 2.2. Resonance.-
2.3. Behaviour of a sample of nuclei.- 2.4. Proton density, tissue
characteristics.- 2.5. Spin echo technique.- 3. The equipment.-
3.1. Magnet.- 3.2. Gradient system.- 3.3. Coils.- 3.4. Computer.-
4. Disadvantages of MR imaging.- 4.1. Claustrophobia.- 4.2.
Contra-indications.- References.- 5: MR Imaging Techniques of the
Larynx.- 1. Surface coils.- 1.1. Coil selection.- 2. Parameters.-
2.1. Pulse sequences.- 2.2. Slice thickness.- 2.3. Slice
direction.- 2.4. Matrix size.- 2.5. Number of signal measurements.-
3. Artifacts.- 3.1. Motion artifacts.- 3.2. System artifacts.- 3.3.
Chemical shift artifacts.- 3.4. Artifacts due to ferromagnetic
implants.- 4. Performance of the laryngeal examination.-
References.- 6: MR Imaging of the Normal Larynx.- 1. Introduction.-
2. MR imaging of laryngeal structures.- 2.1. Laryngeal skeleton.-
2.2. Laryngeal compartments.- 3. Landmarks.- 3.1. Hyoid bone.- 3.2.
Aryepiglottic fold.- 3.3. False vocal cords.- 3.4. True vocal
cords.- 3.5. Subglottic level.- References.- 7: MR Imaging of
Laryngeal Cancer.- Abstract.- 1. Introduction.- 2. Materials and
methods.- 3. Case reports.- Case 1.- Case 2.- Case 3.- Case 4.-
Case 5.- Case 6.- Case 7.- 4. Discussion.- 5. Conclusions.-
References.- 8: MR imaging of Normal and Cancerous Laryngeal
Cartilages. Histopathological Correlation.- Abstract.- 1.
Introduction.- 2. Materials and methods.- 3. Results.- 3.1.
Epiglottic cartilage.- 3.2. Thyroid cartilage.- 3.3. Cricoid
cartilage.- 3.4. Arytenoid cartilage.- 4. Discussion.- 5.
Conclusions.- References.- 9: Dagnosis of Laryngeal Cartilage
Invasion by Cancer. Comparison of CT and MR Imaging.- Abstract.- 1.
Introduction.- 2. Materials and methods.- 2.1. Imaging techniques.-
2.2. Image interpretation.- 2.3. Pathological findings.- 3.
Results.- 3.1. Epiglottic cartilage.- 3.2. Thyroid cartilage.- 3.3.
Arytenoid cartilage.- 3.4. Cricoid cartilage.- 3.5. Group of
patients for which no pathologic correlation was available.- 3.6.
Movement artifacts.- 4. Discussion.- 4.1. Elastic cartilage:
epiglottic cartilage.- 4.2. Hyaline cartilage: thyroid, cricoid and
arytenoid cartilages.- 5. Summary.- References.- 10: MR Findings of
Cartilage Invasion by Laryngeal Cancer. Value in Predicting Outcome
of Radiation Therap...
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