鼻咽癌淋巴结转移诊断中磁共振成像RTOG分区研究  

作　　者：李国华[1] 吴继雄 

机构地区：[1]广东省江门市人民医院放射科,广东529000 [2]广东省惠州市中信惠州医院放射科

出　　处：《当代医学》2015年第8期55-56,共2页Contemporary Medicine

摘　　要：目的探讨鼻咽癌淋巴结转移诊断中磁共振成像RTOG分区的诊断价值。方法选取收治的伴有淋巴结转移的鼻咽癌患者100例,患者均进行常规鼻咽部磁共振成像平扫和增强检查,利用RTOG分区的方法进行淋巴结分区,观察其结果。结果在横断位磁共振成像上均可清晰地辨别出RTOG分区的标志。100例伴有淋巴结转移的鼻咽癌患者中,有30例患者出现淋巴结坏死,占30%;有20例患者出现包膜外侵犯,占20%;有5例患者出现跳跃性转移,占5%;45例患者出现RTOG分区之外的淋巴结侵犯,占45%。其中,在Ⅱb区上界以上的范围内有30例,斜方肌前缘以后的范围出现3例,在Ⅳ区的下界以下的范围内有12例,未发现有单纯发生在RTOG分区之外的淋巴结转移患者。结论磁共振成像能够对颈部淋巴结进行RTOG分区,同时能够准确的勾画出鼻咽癌淋巴结转移的颈部靶区。鼻咽癌淋巴结转移有循序性,呈由上而下逐渐减少,且跳跃性转移率低。咽后及Ⅱ区最易受累,其次是Ⅲ、Ⅴ和Ⅳ区,Ⅰb区极少受累。RTOG分区对鼻咽癌淋巴结转移具有良好的诊断价值。Objective To investigate diagnosis value of magnetic resonance imaging RTOG partition in the diagnosis of the lymph node metastasis of nasopharyngeal carcinoma. Methods 100 patients with nasopharyngeal carcinoma with lymph node metastasis were selected, all patients were checked normal nasopharynx MRI plain scan and enhancement scan, lymph node partition method using RTOG partition, and observed the results. Results In the axial magnetic resonance imaging can clearly distinguish mark RTOG partition. 100 cases of nasopharyngeal carcinoma patients with lymph node metastasis, 30 patients（30%） were found to have lymph node necrosis;there were 20 cases （20%） of extracapsular invasion;5 patients（5%） were found to have metastasis; 45 patients（45%） had RTOG partition outside the lymph node involvement, among them, in the second area above B upper bound of the range in 30 cases, the scope of the trapezius muscle front later appeared in 3 cases involved, in the range of lower IV area under the 12 cases, there was no isolated in the RTOG partition outside of the patients with lymph node metastasis. Conclusion Magnetic resonance imaging to cervical lymph node of RTOG partition can accurately delineate the target region of neck lymph node metastasis in nasopharyngeal carcinoma. A progressive metastatic lymph node, a top-down gradually reduced, and the jump the low transfer rate. Retropharyngeal and area II most affected, followed by the III and IV, V, I rarely affected area B. The RTOG partition on nasopharyngeal carcinoma lymph node metastasis has good diagnostic value.

关 键 词：鼻咽癌淋巴结转移 磁共振成像 RTOG分区 

分 类 号：R739.63[医药卫生—肿瘤]