鼻咽癌放疗后局部复发特殊类型的MR诊断  

Local Recurrence of Nasopharyngeal Carcinoma with Normal Mucous Membr ane after Radiation therapy: MR Imaging Findings

作　　者：龙晚生[1] 汤积耀[1] 罗学毛[1] 宋彬[2] 徐隽[3] 陈卫霞[2] 

机构地区：[1]广东省江门市中心医院放射科,江门529070 [2]华西医科大学附属第一医院放射科 [3]都江堰市人民医院放射科

出　　处：《华西医科大学学报》2001年第1期126-128,119,共4页Journal of West China University of Medical Sciences

摘　　要：目的　探讨鼻咽癌放疗后局部复发的类型及其 MR表现。方法　选择鼻咽癌放疗后鼻咽腔粘膜正常 ,但鼻咽周围肿块复发者 2 4例 ,按常规及 Gd- DTPA增强后行 MR检查。结果　 1茎突前间隙复发 8例 ,7例伴有颅底和颅内侵犯 ;2茎突后间隙复发 2例 ;3颅底骨质破坏 7例 ;4鼻腔及筛窦复发 3例 ;5鼻咽腔粘膜下囊性复发 2例 ;6其他类型复发 2例。其中 15例还经病理证实 ,9例经再程放疗和追踪观察确诊。在 MR表现上除囊性复发 2例外 ,其余病例病灶在 T1加权像均呈稍低或等信号 ,T2加权像呈稍高信号 ,增强后有中等度以上强化。结论　鼻咽癌放疗后复发存在多种特殊类型 。Objective The purpose of this work was to investigate and analyze the MR imaging features of postradiation local recurrence of nasopharyngeal carcinoma(NPC) wit h normal mucous membrane. Methods 24 such cases were studied. T he diagnosis of NPC recur rence was pathologically confirmed in 15 patients, and was corroborated by repea ted radiation therapy and serial follow ups in 9 patients. MR imaging routine p r ocedures and Gd DTPA enhancement were performed for all patients. Resu lts The MR imagi ng findings were as follows: ① The recurrent tumor mass was located in the pres tyloid space in 8 patients, with skull base erosion and intracranial infiltratio n in 7 patients; ② Retrostyloid space recurrence in 2 patients; ③ Direct bony erosion of the skull base in 7 patients; ④ Recurrence in nasal cavity and ethmo id sinuses in 3 patients; ⑤ Submucous cystic recurrence in 2 patients; ⑥ Mixed patterns of recurrence in 2 patients. Except 2 cases of cystic tumor recurrence , all cases exhibited slight hypo or iso intensity on T1 weighted images, s light hyper intensity on T2 wighted images, and moderate to marked enhancement after Gd DTPA administration. Conclusion There are several sp ecial patterns of local NPC tumor recurrence after radiation therapy in the pres ence of normal nasopharyngeal mucosa. MR imaging is the method of choice to depi ct the location and extent of NPC tumor recurrence.

关 键 词：鼻咽肿瘤 肿瘤复发 放射治疗 磁共振成像 MR 

分 类 号：R739.63[医药卫生—肿瘤] R445.2[医药卫生—临床医学]