[Imaging diagnosis of head and neck cancer--diagnosis of laryngeal cancer, hypopharyngeal cancer and cancer of the cervical esophagus by CT x-ray].
Fifty-six patients with laryngeal cancer were examined. The rate of correct diagnosis of clinical staging was 64.3%. Whereas the rate of correct diagnosis of staging by CT was markedly improved, 89.3%. In particular, CT facilitated correct diagnosis of T4. Supraglottic T3 cancer is diagnosed on the basis of deep infiltration or fixation of the hemi-larynx. Disappearance of the pre-epiglottic space or ulcer formation was recognized as a CT finding of deep infiltration. Disappearance of the paraglottic space and dislocation of the arytenoid cartilage were used as the standard for CT findings of laryngeal T3 cancer. CT allowed diagnosis to be made in 84.4% of cases which were pathologically determined to be T4. It can be said that CT is a very effective method for staging diagnosis in patients with laryngeal cancer. Fifty-seven patients with hypopharyngeal cancer and cancer of the cervical esophagus were also examined. When 40 post-surgical patients were compared according to pathological classification of T, the rate of correct diagnosis of clinical staging was 77.5% while that of staging diagnosis by CT was 82.5%. The rate of correct diagnosis by postoperative CT was 80.0% compared with the pathological determination of depth of invasion. The diagnosis of depth of invasion by CT on initial examination is thus an effective means for the determination of prognosis.