64排螺旋CT扫描及多平面重建对早期鼻咽癌及周围骨质破坏诊断价值  

Diagnostic value by 64 slice spiral CT and multiplanar reconstruction for early nasopharynx cancer and peripheral bone destruction

作　　者：苏显球 余光权 陈敏明 

机构地区：[1]广东省阳春市人民医院,529600

出　　处：《中国实用医药》2016年第34期90-92,共3页China Practical Medicine

摘　　要：目的通过64排螺旋CT扫描及多平面重建对早期鼻咽癌及周围骨质破坏的诊断价值进行分析。方法对经64排螺旋CT扫描及多平面重建的42例鼻咽癌患者的临床资料进行回顾性分析。结果 42例鼻咽癌患者影像结果显示:(1)鼻咽侧壁改变33例,鼻咽一侧或双侧壁增厚26例;(2)鼻咽腔结构变形,咽鼓管圆枕肿大,一侧或双侧咽隐窝消失17例,鼻咽壁增厚及组织肿块导致咽隐窝消失、变平及移位,突入鼻咽腔致其不对称狭窄或闭塞;(3)咽旁间隙受累13例,表现咽旁间隙显示欠清,咽旁间隙的脂肪结构消失及不规则软组织肿块,引起咽旁间隙变形、移位甚至消失;(4)颅底骨质破坏12例,CT显示颅底骨质呈"虫蚀"样改变。正常骨形态消失,部分骨质边缘不规则缺损,缺损骨质为软组织替代;(5)颈部淋巴结转移23例,CT显示颈部单侧或多个软组织样密度影,有强化,部份融合成团块状改变,增强扫描有强化。淋巴结肿大者可发生液化坏死,以上颈部多见。结论 64排螺旋CT对鼻咽癌早期诊断及周围骨质破坏诊断研究及早期临床治疗具有重要价值。Objective To analyze diagnostic value for early nasopharynx cancer and peripheral bone destruction through 64 slice spiral CT and multiplanar reconstruction. Methods A retrospective analysis was made on clinical data of 42 medical cases with nasopharynx cancer, who received 64 slice spiral CT and multiplanar reconstruction. Results Imaging outcomes in 442 patients with nasopharynx cancer showed as followed.（1） There were 33 cases with changed lateral pharyngonasal wall and 26 cases with unilateral or bilateral thickened pharyngonasal wall.（2） There were 17 cases with pharyngonasal cavity deformation, swelling tubal torus, unilateral or bilateral pharyngeal recess disappearance. Disappeared, flattened or shifted pharyngeal recess was caused by thickened pharyngonasal wall and tissue lump. Asymmetric stenosis or closure was caused by pharyngonasal cavity invasion.（3） There were 13 cases with involved parapharyngeal space, with manifestations ofunclear parapharyngeal space, disappeared fat structure in parapharyngeal space, and irregular tissue lump, which led to deformation, shift and disappearance of parapharyngeal space.（4） There were 12 cases with basicranial bone destruction, which were shown by CT as＂ worm-eaten＂ destruction. Normal bone form disappeared with irregular defected edge and replaced by soft tissue.（5） There were 23 cases with cervical lymph node metastasis. CT showed unilateral or multiple intensified neck soft tissue density images, and some of them had crumb changes with intensification by enhancement scan. Lymphadenectasis cases had possibility of liquefactive necrosis mainly in neck. Conclusion 64 slice spiral CT contains important value for early diagnosis of nasopharynx cancer, diagnosis and research of peripheral bone destruction, and early clinical treatment.

关 键 词：鼻咽癌 64排螺旋CT 多平面重建 诊断价值 

分 类 号：R739.63[医药卫生—肿瘤]