鼻咽癌咽后淋巴结转移的CT与MRI对比研究  

Assessment of Retropharyngeal Lymph Node by Comparing CT with MRI

作　　者：谢传淼[1] 梁碧玲[2] 林浩皋[1] 吴沛宏[1] 

机构地区：[1]中山大学肿瘤防治中心影像介入科,广东广州510060 [2]中山大学孙逸仙纪念医院放射科,广东广州510120

出　　处：《癌症》2002年第3期285-288,共4页Chinese Journal of Cancer

摘　　要：背景与目的:鼻咽癌是我国南方地区高发的恶性肿瘤,国外有些学者曾有过对鼻咽癌进行CT与MRI比较,但未有对鼻咽癌咽后淋巴结转移进行单独论述;国内目前也没有相关的论述。本研究通过对56例鼻咽癌的CT、MRI扫描所见进行比较分析,探讨CT与MRI对发现鼻咽癌咽后淋巴结转移的价值。方法:选取自1993年8月至2000年12月病理证实为鼻咽癌病例56例,CT扫描机是ElscientCTTwinflash,常规横断平扫,3例加冠状扫描,其中的16例直接增强扫描;MRI成像使用PhiliPT5-Ⅱ型0.5Tesla超导磁共振成像系统,标准头部正交线圈,常规SE序列,扫描方向为横断面、矢状面、冠状面,扫描范围上达鞍上池,下至第二颈椎下缘水平,大部分病例增强扫描(50/56)。结果:MRI可以准确区分鼻咽癌颈动脉鞘区肿瘤侵犯还是咽后淋巴结转移,较CT明确(CT13例,MRI24例)。统计学上有显著性差异(P<0.05)。结论:MRI可以区分肿瘤直接侵犯颈动脉鞘区还是咽后淋巴结转移,因而较CT更准确划分肿瘤的侵犯范围,对我国的92分期影响较明显,可以更准确地进行鼻咽癌的临床分期。Background &Objectives:The incidence of nasopharyngeal carcinoma (NPC)is high as part of malignancy of head and neck in South China.Some of the foreign radiologis ts investigated on it by comparing CT(computed tomography)with MRI (magnetic resonance imaging),but there was no description for metastatic retropharyngeal lymph node(RPN)of NPC.None of this kind of article published in domestic.The current stu dy was designed to evaluate CT and MRI in identifying retropharyngeal node by comparing the finding of CT an d MRI in 56patients with NPC.Methods:Fifty-six cases pathologically pro ven as nasopharyngeal carcinoma were selected from August,1993to Decem ber,2000;CT scan were performed by Elscient CT Tw in flash,axial scan were parallel to the OM line routinely from soft palate to the supracellar cistern.MRI scan were p erformed by Philip T5-Ⅱsuper-conducting magnetic resonan ce imaging system(0.5T).The standard quadrature head coil wa s used.Routine axial,saggital,and coronal scan with SE sequences were o btained.Scanned field ranged from soft palate to the supracellar cistern.After p lain scaned,contrast material were administrated in40cases by intravenous injection of Gd-DTPA 0.1mmol per kilogram body we ight.And then repeat axial,saggita l and coronal scan.Results:MRI recovered the RPN more exactly th an CT(13cases by CT and 24cases by MRI )and there was significant differentiation 0(P<0.05).It is possible to distinguish the me tastatic RPN of NPC from the directly infiltration of tumor by MRI.Conclusions:MRI is more precise than CT in differe ntiating the RPN from the directly in vasion by tumor tissue of NPC,which will affects the92Chinese staging systems,for NPC obviously.

关 键 词：鼻咽肿瘤 咽后淋巴结 电子计算机断层扫描 磁共振成像 肿瘤转移 CT MRI 对比研究 

分 类 号：R739.63[医药卫生—肿瘤]