鼻咽癌去神经肌肉病变的MRI表现  

MRI manifestations of denervated muscular lesions in patients with nasopharyngeal carcinoma

作　　者：钟清木[1] 黄日升[1] 陈子龙 洪芙蓉 ZHONG Qing-mu;HUANG Ri-sheng;CHEN Zi-long;HONG Fu-rong(Quanzhou First Hospital Affiliated to Fujian Medical University,Quanzhou Fujian 362000,China)

机构地区：[1]福建医科大学附属泉州第一医院,福建泉州362000

出　　处：《中国临床医学影像杂志》2024年第1期17-20,25,共5页Journal of China Clinic Medical Imaging

基　　金：泉州市科技计划项目,编号:2019N023S。

摘　　要：目的:观察鼻咽癌患者去神经肌肉病变(DML)的MRI表现。方法:回顾性分析本院2010年2月—2022年2月12例鼻咽癌患者DML的临床资料及MRI图像,观察其MR信号变化、病变强化及扩散加权成像等的表现特点。结果:在12例鼻咽癌患者DML中有4例为三叉神经下颌支支配的咀嚼肌出现DML,8例为舌下神经支配的舌肌出现DML。在4例咀嚼肌DML中,2例为肿瘤复发二程放疗后出现,2例为首程放疗后进展出现;8例舌肌DML中有4例为首程放疗后出现,3例为肿瘤复发二程放疗后出现,1例在初诊时出现。在4例咀嚼肌DML中均观察到肌肉萎缩,2例可看到脂肪替代信号,在T_(1)WI呈高信号,另外2例在T_(1)WI呈等信号,没有观察到脂肪替代信号,在T_(2)WI呈不均匀中高信号,DWI也呈高信号,增强后轻到中度强化;在8例舌肌DML中也都看到肌肉萎缩,在T_(1)WI可观察到脂肪替代信号,其中有5例在T_(2)WI及DWI呈等信号,增强后未见明显强化,3例在T_(2)WI及DWI呈高信号,增强后轻到中度的强化。结论:鼻咽癌合并咀嚼肌或舌肌DML较为少见,但其MRI表现具有一定的特征性,识别其MRI的信号表现有助于DML的早期诊断,并与炎症或肿瘤浸润相鉴别。Objective:To observe the MRI manifestations of denervated muscular lesions(DML) in patients with nasopharyngeal carcinoma.Methods:The clinical data and MRI images of DML in 12 patients with nasopharyngeal carcinoma were retrospectively analyzed in our hospital from February 2010 to February 2022.The characteristics of MRI signals,lesion enhancement,and DWI were observed.Results:Among the DML of 12 patients with nasopharyngeal carcinoma,4 cases showed DML in the masticatory muscles innervated by the mandibular branch of the trigeminal nerve and 8 cases showed DML in the lingual muscles innervated by the hypoglossal nerve.Among the 4 cases of DML in the masticatory muscle,2 cases occurred DML after secondary radiotherapy for tumor recurrence,and 2 cases developed DML after initial radiotherapy.Among the 8 cases of DML of the tongue muscles,4 cases appeared after the first course of radiotherapy,3 cases occured after secondary radiotherapy,and 1 case emerged at the initial diagnosis.Muscle atrophy was observed in 4 cases of DML,with two cases showing fat replacement signal and high signal on T_1WI,while the other two cases showed isointense signal on T_(1WI) and no fat replacement signal was observed.On T_2WI,they showed uneven medium high signal and DWI also showed high signal,with mild to moderate enhancement after enhancement.Muscle atrophy was also observed in 8 cases of tongue muscle DML,and fat replacement signals were observed on T_1WI.Among them,5 cases showed equal signals on T_(2WI) and DWI,but no significant enhancement was observed after enhancement.Three cases showed high signal on T_(2WI) and DWI,with mild to moderate enhancement after enhancement.Conclusion:Nasopharyngeal cancer with DML of the masticatory or tongue muscles is relatively rare,but its MRI manifestations have certain characteristics.Identifying the signal manifestations of its MRI can help in the early diagnosis of DML and differentiate it from inflammation or tumor infiltration.

关 键 词：鼻咽癌 磁共振成像 

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