探究鼻咽部低分化鳞状细胞癌的MRI诊断  

MRI Diagnosis of Poorly Differentiated Squamous Cell Carcinoma of Nasopharynx

作　　者：刘成 Liu Cheng(Shenzhen Bao'an District Maternal and Child Health,Shenzhen 518000,China)

机构地区：[1]深圳市宝安区妇幼保健

出　　处：《哈尔滨医药》2019年第4期333-335,共3页Harbin Medical Journal

基　　金：深圳市南山区科技计划项目(2018040)

摘　　要：目的 探讨鼻咽部低分化鳞状细胞癌的MRI诊断价值。方法 选择2016年1月至2018年9月在本院治疗的42例鼻咽部低分化鳞状细胞癌作为研究对象,42例患者活检前使用GESigna3.0T超导型磁共振成像仪进行鼻咽部扫描,统计患者病理组织学检查结果,与MRI诊断结果比较,对比两者在肿瘤分期、分型方面的诊断结果,同时观察MRI对直接扩散侵犯及其他征象检出情况。结果 MRI诊断40例(95.24%)患者为鼻咽癌,2例(4.76%)患者诊断不明。MRI与病理诊断肿瘤分期结果比较符合率为95.38%(40/42)。MRI与病理诊断肿瘤分型结果比较符合率为92.86%(39/42)。42例患者直接扩散的瘤灶均与原发癌瘤相续,MRI检出侵犯情况较为复杂,部分患者合并乳突炎、上颌窦炎、下鼻甲肿大、筛窦炎、咽后淋巴结肿大等征象。MRI信号强度特征:T2WI高信号(52.38%)和等信号(42.86%)占比显著高于略高信号(4.76%),差异有统计学意义(P<0.05);T2WI不均匀31例(73.81%),信号均匀者11例(26.19%);T1WI等信号者占比(83.33%)显著高于高信号(7.14%)和略高信号(95.24%),差异有统计学意义(P<0.05);T1WI信号均匀15例(35.71%),不均匀27例(64.29%)。结论 MRI对鼻咽部低分化鳞状细胞癌肿瘤分期、分型诊断准确性较高,且可有效检出直接扩散及侵犯情况,临床应用价值较高。Objective To investigate the value of MRI in the diagnosis of poorly differentiated squamous cell carcinoma of nasopharynx.Methods From January 2016 to September 2018,42 patients with poorly differentiated squamous cell carcinoma of nasopharynx were treated with GE Signa3.before biopsy.The nasopharynx was scanned by 0T superconducting magnetic resonance imager,and the results of histopathological examination were counted,and compared with the diagnostic results of MRI,the diagnosis results of tumor staging and classification were compared.At the same time,the detection of direct diffusion invasion and other signs by MRI was observed.Results 40 cases were diagnosed by MRI(95.24%)two cases(4.76%)of nasopharyngeal carcinoma were diagnosed unclearly.The coincidence rate between MRI and pathological diagnosis of tumor staging was 95.38%(40/42).The coincidence rate between MRI and pathological diagnosis of tumor classification was 92.86%(39/42).42.MRI detection of invasion is more complex,Some patients with mastoiditis,maxillary sinusitis,inferior turbinomegaly,ethmoid sinusitis,retropharyngeal lymphadenopathy,etc.MRI signal intensity features:high signal intensity on T2WI(52.38%)and isointense(42.2%)The proportion of signal on T _ 2WI was significantly higher than that on hyperintensity(4.76%),the difference was statistically significant(P<0.05).The proportion of homogeneous signal on T _ 2WI was significantly higher in 11 cases(26.19%)than that in high signal(7.14%)and slightly high signal(95.24%)(P<0.05).T1WI signal was homogeneous in 15 cases(35.71%)and uneven in 27 cases(64.29%).Conclusion MRI is useful in the staging and typing of poorly differentiated squamous cell carcinoma of nasopharynx.The accuracy of diagnosis is high,and the direct diffusion and invasion can be detected effectively,and the clinical application value is high.

关 键 词：鼻咽部 低分化鳞状细胞癌 磁共振成像诊断 肿瘤分期 

分 类 号：R739.6[医药卫生—肿瘤]