磁共振成像 (MRI) 是口咽癌 (OPC) 的首选成像方式，但难以区分小 OPC 和单侧扁桃体肥大。我们假设外科医生进行的经口超声 (US) 可用于准确检测 T 期 OPC。我们进行了一项单中心前瞻性诊断准确性研究，研究对象包括门诊预约期间疑似或活检证实 OPC 的患者。所有患者均接受经口超声和 MRI 检查。如果患者无法耐受经口超声，则进行经宫颈超声。主要结果是使用组织病理学作为参考标准，与 MRI 相比，超声检测 OPC 的诊断准确性。次要结果是在不知情的情况下比较超声和 MRI 之间的原发肿瘤直径。在该研究的 26 名患者中，21 名 (81%) 患有 OPC。经口超声可分别对 21/21 和 1/5 疑似腭和舌扁桃体 OPC 的患者进行。总体而言，US 诊断准确率为 92%，而 MRI 诊断准确率为 81% (p = 0.37)。 US 和 MRI 前后径中的肿瘤直径之间具有高度相关性（R = 0.80，p < 0.001），对应于 US 的深度轴。总之，这项小型研究显示了经口超声在改善疑似 OPC 患者的初步临床评估方面的前景和可行性。

Magnetic resonance imaging (MRI) is the preferred imaging modality for oropharyngeal cancers (OPCs), but it has difficulties distinguishing between small OPCs and unilateral tonsil hypertrophy. We hypothesized that surgeon-performed transoral ultrasound (US) could be used to accurately detect T-stage OPCs. We performed a single-center prospective diagnostic accuracy study including patients with suspected or biopsy-verified OPCs during outpatient appointments. All patients were offered transoral US and MRI. If transoral US could not be tolerated by the patient, transcervical US was performed. The primary outcome was the diagnostic accuracy of detecting OPCs with US compared to MRI, using histopathology as the reference standard. The secondary outcome was comparing the primary tumor diameters between US and MRI blinded to each other. Out of the 26 patients included in the study, 21 (81%) had OPCs. Transoral US could be performed in 21/21 and 1/5 patients with suspected palatine and lingual tonsil OPCs, respectively. Overall, US diagnostic accuracy was 92%, compared to 81% with MRI (p = 0.37). US and MRI had a high correlation between tumor diameters in the anteroposterior diameter (R = 0.80, p < 0.001), corresponding to the depth axis on US. In conclusion, this small study showed the promise and feasibility of transoral US to improve the initial clinical evaluations of patients with suspected OPCs.