鼻咽癌放疗术后MRI征象分析

Analysis of MRI features after radiotherapy of nasopharyngeal carcinoma

目的分析鼻咽癌放疗术后的MRI征象,并初步探讨咽隐窝变浅或消失与鼻咽癌放疗后复发的关系。方法搜集44例鼻咽癌放疗术后患者,分别行冠状位、轴位T1与T2快速自旋回波和T2WI脂肪抑制序列扫描,其中15例患者行增强MRI检查。随机选择20例正常人,分别测量其两侧咽隐窝深度,行t检验分析。42例患者分别测量双侧咽隐窝深度,并与鼻咽癌放疗后复发,进行χ2检验,分析两者间有无相关性。结果44例鼻咽癌放疗后MRI征象:①局部黏膜明显增厚复发3例,黏膜萎缩2例;②鼻窦炎39例,乳突炎23例;③邻近结构侵犯5例,主要侵犯斜坡、翼内外肌、中颅窝底、咽旁间隙及颈前软组织;④颈部淋巴结肿大转移6例。结论鼻咽癌放疗术后MRI复查,不仅可清楚显示放疗后改变,同时如一侧咽隐窝仍变浅或消失,高度提示肿瘤存在复发可能,有利于早期诊断,为临床进一步治疗提供依据。

Objective Toanalyze MRI features after radiotherapy of nasopharyngeal carcinoma,and explore the correlation between shoal or disappear in pharyngeal recess and recurrences after radiotherapy of nasopharyngeal carcinoma. Methods 44 cases after radiotherapy of nasopharyngeal carcinoma were examined by MRI, among which 15 cases received enhanced scanning . Bi-lateral depth of pharyngeal recess in 20 persons who have no nasopharyngeal carcinoma were analyzed by t test.It was explored the correlation between shoal or disappear in pharyngeal recess and recurrences after radiotherapy of nasopharyngeal carcinoma by χ2 test. Results 44 cases after radiotherapy of nasopharyngeal carcinoma image features were following : ①local mucosa incrassation recurrences in 3 cases ,mucosa atrophy in 2 cases;② nasosinusitis in 39 cases , mastoiditis in 23 cases;③adjacent structure destruction in 5 cases, involvement in clivus, muscle pterygoideus lateralis or medialis ,middle cranial base, parapharyngeal clearance , soft tissues before cervix vertebra ;④metastasis of cervix lymph nodes in 6 cases. Conclusion MRI examination for patients after radiotherapy of nasopharyngeal carcinoma not only can show clearly changes after radiotherapy and prompt highly recurrences in patient with shoal or disappear in pharyngeal recess , but provide evidences to treat early diagnosis of recurrence of nasopharyngeal carcinoma .