MRI与CT诊断鼻咽癌颅底骨质侵犯的临床价值比较  

Comparison of the clinical value of MRI and CT in the diagnosis of nasopharyngeal carcinoma

作　　者：李少朋[1] 程传东[2] 邓克学[1] LI Shaopeng;CHENG Chuandong;DENG Kexue(Department of Radiology,the First Affiliated Hospital of USTC,Southern District of Anhui Provincial Hospital,Hefei 230032,China;Department of Neurosurgery,the First Affiliated Hospital of USTC,Anhui Provincial Hospital,Hefei 230032,China)

机构地区：[1]安徽省立医院南区影像科,合肥230032 [2]安徽省立医院南区神经外科,合肥230032

出　　处：《磁共振成像》2020年第12期1167-1169,1185,共4页Chinese Journal of Magnetic Resonance Imaging

基　　金：安徽省科技厅联合项目(编号:WK9110000032)。

摘　　要：目的研究MRI和CT在鼻咽癌颅底骨质侵犯临床诊断中的应用价值。材料与方法回顾性分析2018年2月至2020年7月于本院接诊的70例鼻咽癌患者完整临床资料,所有患者均经病理证实,将患者临床症状、影像资料以及随访等综合结果作为颅底骨质受侵的判定标准,统计分析CT和MRI对诊断鼻咽癌颅底骨质侵犯的价值。结果鼻咽癌颅底骨质侵犯在CT上主要表现为骨皮质增厚模糊或增生硬化、单或多部位虫蚀样骨质破坏;MRI上主要表现为骨髓高信号消失呈中等信号。70例患者中,CT诊断颅底骨质受侵者24例,检出率为34.3%,其中多部位受侵者17例。MRI诊断颅底骨质受侵者51例,检出率为72.9%,其中多部位受侵者31例,两种检查方法检出率比较差异有统计学意义(P<0.05)。CT和MRI检查均显示颅底骨质侵犯岩锥尖发生率较高。结论 MRI在鼻咽癌颅底骨质侵犯诊断中能显著提高检出率,为临床医师治疗方案的选择提供了影像依据。Objective:To study the application value of MRI and CT in the clinical diagnosis of skull base bone invasion in nasopharyngeal carcinoma.Materials and Methods:To retrospectively analyze the complete clinical datas of 70 patients with nasopharyngeal carcinoma who were pathologically confirmed in our hospital from February 2018 to July 2020.The comprehensive results of the patients’clinical symptoms,imaging data and followup were taken as the skull base bone invasion criteria,then to analysis of the value of CT and MRI in the diagnosis of nasopharyngeal carcinoma skull base bone invasion.Results:Bone invasion of nasopharyngeal carcinoma skull base on CT is mainly manifested as thickening of cortical bone or hyperplasia and sclerosis,single or multi-site worm-like bone destruction;MRI is mainly manifested as bone marrow high signal displaced by medium signal.Among 70 patients,24 patients were diagnosed as skull base bone invasion with CT,the detection rate was 34.3%,of which 17 cases were invaded by multiple sites.51 cases of skull base bone invasion were diagnosed by MRI,of which including 31 cases of multi-site invasion,the detection rate was 72.9%,the detection rate of the two examination methods was statistically different(P<0.05).Both CT and MRI examinations showed a higher incidence of the skull base bone invading the petrosal tip.Conclusions:MRI can significantly improve the detection rate in the diagnosis of nasopharyngeal carcinoma with bone invasion of the skull base,which provides imaging basis for clinicians to choose the treatment plan and is worthy of promotion.

关 键 词：鼻咽癌 诊断价值 磁共振成像 检出率 颅底侵犯 电子计算机断层扫描 

分 类 号：R445.2[医药卫生—影像医学与核医学] R739.62[医药卫生—诊断学]