鼻咽癌颈部淋巴结转移的CT表现及放疗后局部复发的CT特点研究  

Research of CT Performance for Cervical Lymph Node Metastasis and CT Features of Local Recurrence after Radiotherapy in NPC

作　　者：曾卓辉 林岗[1] 梁德贤[2] 

机构地区：[1]广东省江门市新会人民医院影像科,广东江门529000 [2]广东省湛江中心人民医院内科,广东湛江524037

出　　处：《中国CT和MRI杂志》2016年第3期14-17,共4页Chinese Journal of CT and MRI

基　　金：湛江市科技攻关计划项目;项目编号NO:2013B01031

摘　　要：目的探讨鼻咽癌颈部淋巴结转移的CT表现及放疗后局部复发的CT特点研究。方法纳入我院2000年1月-2015年1月进行CT检查并经过病理检查确诊为鼻咽癌患者200例。分析患者颈部淋巴结转移的CT图像,并与病理结果进行对比。另择取放疗复发的患者100例,分析患者的CT图像,并进行总结。结果经病理检查确诊为鼻咽癌的200例患者中,经CT检查发现发生颈部淋巴结转移患者有176例(88%)。其中咽后组、颈上深组、颈后三角区、颈中深组、颈下深组、锁骨上区淋巴转移率分别为59.7%、74.4%、25.6%、62.9%、49.3%、27.6%。而颌下淋巴结、颏下淋巴结以及腮腺内淋巴结转移率分别为7.3%、1.7%以及2.8%。162例患者增强扫描发现,淋巴结轻、中度强化患者95.51%,无强化患者1.28%,明显强化患者0.64%。在转移的淋巴结中密度均匀及不均匀的分别为50.6%、35.8%。6.8%出现大片坏死区,7.4%出现环状低密度区。鼻咽癌复发部位多为鼻咽部,本次观察94例均为鼻咽部复发,5例患者为单纯颅底复发,另1例为单纯颈部淋巴结复发;48例出现颈部淋巴结复发,其中双侧颈部淋巴结复发20例,其余均为单侧复发。结论鼻咽癌患者中淋巴结转移较为常见,多为咽后及颈静脉淋巴,其CT下典型表现为密度均匀,较为规则。Objective To study the CT performance for cervical lymph node metastasis and CT features of local recurrence after radiotherapy in NPC. Methods From January 2000 to January 2015, 200 NPC patients received CT scanning and were clinically confirmed in our hospital. CT imaging about cervical lymph node metastasis was analyzed and the pathological results were compared. CT imaging about 100 recurrent cases after radiotherapy was concluded. Results Results Through CT examination, the incidence rate of cervical lymph node metastasis was 88%（176/200）; the rates of metastasis in retropharyngeal, superior deep cervical area, posterior triangle and neck, middle deep cervical area, interior deep cervical area and supraclavicular area were 59.7%, 74.4%, 25.6%, 62.9%, 49.3% and 27.6%; the rates of metastasis in submandibular lymphatic node, submental node and intraglandular parotid node were 7.3%, 1.7% and 2.8%. Based on CT enhancement scanning, 95.51% of lymph nodes were slightly and moderately enhanced with 1.28% of non-enhancement cases and 0.64% of significant enhancement cases. 50.6% of lymph nodes were evenly distributed; 35.8% of nodes were not evenly distributed. 6.8% of lymph nodes contained large areas of necrosis; 7.4% of nodes contained cyclic low-density areas. NPC majorly re-appeared in nasopharyngeal region. There were 94 recurrent cases in nasopharyngeal region, 5 cases in skull base, and 1 case of cervical lymph node; there were 48 cases of cervical lymph nodes with 20 cases in bilateral sides and the other cases in unilateral side. Conclusion For NPC patients, it is easy to appear the cervical lymph node metastasis, especially in retropharyngeal area and jugular vein. CT is typically appeared with a uniform density and in a regular way.

关 键 词：鼻咽癌 部淋巴结转移 放疗后复发 

分 类 号：R739.62[医药卫生—肿瘤] R445.3[医药卫生—临床医学]