鼻咽癌颅底骨质侵犯的CT与MRI征象及其诊断价值  

CT and MRI signs and diagnostic value of skull base bone invasion in nasopharyngeal carcinoma

作　　者：张健楠 张桂荣 张妍妍 张博[1] 孙泓泓[1] ZHANG Jiannan;ZHANG Guirong;ZHANG Yanyan;ZHANG Bo;SUN Honghong(Department of Medical Imaging,Second Affiliated Hospital of Xi'an Jiaotong University,Xi'an 710004,China)

机构地区：[1]西安交通大学第二附属医院医学影像科,陕西西安710004

出　　处：《分子影像学杂志》2023年第5期853-857,共5页Journal of Molecular Imaging

基　　金：陕西省社会发展领域一般项目(2023-YBSF-006)。

摘　　要：目的探讨鼻咽癌颅底骨质侵犯的CT与MRI征象及其诊断价值。方法选取2018年4月~2022年7月我院收治的130例鼻咽癌患者作为研究对象。均采用CT及MRI进行检查。统计病理结果,以定性诊断为金标准,记录CT、MRI对颅底骨质侵犯的诊断结果,采用ROC曲线分析CT及MRI检查对鼻咽癌颅底骨质侵犯的诊断价值。结果130例患者经病理活检显示均为鳞状细胞癌,其中有88例分化性非角化型鳞癌,13例分化性角化型鳞癌,29例未分化性鳞癌。定性诊断共检出颅底骨质侵犯98例,检出率为75.38%,CT检查共检出颅底骨质侵犯80例,检出率为61.54%,MRI检查共检出颅底骨质侵犯97例,检出率为74.62%,MRI检查检出率高于CT检查(P<0.05)。MRI检查对鼻咽癌颅底骨质侵犯的诊断敏感度、特异度、准确度分别为95.92%、90.62%、94.62%,均高于CT检查的76.53%、84.37%、78.46%(P<0.05)。结论相比于CT检查,MRI检查对鼻咽癌颅底骨质侵犯的检出率更高,具有较高诊断价值。Objective To explore the CT and MRI signs and value of diagnostic in skull base bone invasion in nasopharyngeal carcinoma.Methods A total of 130 patients with nasopharyngeal carcinoma treated in our hospital from April 2018 to July 2022 were selected as the research subjects.All patients were performed with CT and MRI.The pathological results were counted,qualitative diagnosis was taken as the gold standard,the diagnostic results of CT and MRI for skull base bone invasion were recorded.ROC curve was used to analyze the diagnostic value of CT and MRI for skull base bone invasion of nasopharyngeal carcinoma.Results All 130 patients had squamous cell carcinoma by biopsy,including 88 cases of differentiated non keratinized squamous cell carcinoma,13 cases of differentiated keratinized squamous cell carcinoma,and 29 cases of undifferentiated squamous cell carcinoma.A total of 98 cases of skull base bone invasion were detected by qualitative diagnosis,with a detection rate of 75.38%.80 cases of skull base bone invasion were detected by CT,with a detection rate of 61.54%.97 cases of skull base bone invasion were detected by MRI,with a detection rate of 74.62%.The detection rate of MRI examination was higher than that of CT examination(P<0.05).The diagnostic sensitivity,specificity and accuracy of MRI examination for skull base bone invasion of nasopharyngeal carcinoma were 95.92%,90.62%,94.62%,respectively,which were higher than 76.53%,84.37%,78.46%of CT examination(P<0.05).Conclusion Compared with the CT examination,MRI examination has a higher detection rate of skull base bone invasion in nasopharyngeal carcinoma,which has higher diagnostic value.

关 键 词：鼻咽癌 颅底骨质 电子计算机断层扫描 核磁共振 诊断价值 

分 类 号：R739.63[医药卫生—肿瘤] R445.2[医药卫生—临床医学] R730.44