超声检查在鼻咽癌颈淋巴结转移诊断中的应用

Ultrasonic evaluation of cervical lymph node metastasis in nasopharyngeal cancer

目的探讨经颈超声检查在鼻咽癌及其颈淋巴结转移诊断中的应用价值。方法以CT作为参照,对4例病理已确诊为鼻咽癌的住院患者进行鼻咽部和左右侧颈部超声检查。患者取仰卧位,检查时头略向对侧倾斜,以腮腺及咽旁间隙作为透声窗,取下颌角和乳突间的耳垂下斜横断面和下颌骨升支旁的斜冠状切面显示鼻咽部,测量病理情况下鼻咽部软组织的厚度或肿块的范围,观察其形态、边界、内部回声及与周围组织的关系,然后再用高频探头检查左右侧颈部,并对肿大的淋巴结测量记录。结果4例患者显示6个病灶,其中单侧病灶2例,双侧病灶2例。病灶中低回声4个,中等回声2个,实质性回声6个,夹杂液无回声区1个;声像图表现鼻咽部软组织增厚4个,鼻咽部肿块2个;超声提示4例颈部淋巴结均肿大。结论经颈超声扫查可观察到鼻咽癌相应的鼻咽部软组织异常增厚或肿块的声像表现,有助于鼻咽癌颈部淋巴结转移的诊断。

Objective To study the application of ultrasound for exaamining cervical lymph node metastasis in nasopharyngeal caner. Methods Four patients with nasopharyngeal cancer admitted in our hospital underwent ultrasonography at nasopharyngeal region. Patients laid on their backs and turned their heads slightly to the opposite side. The parotid and pharynx gap served as the sound penetrating window to show the nasopharyngeal part through the cross section between lower jaw and lower earlobe, as well as oblique coronary section near the mandibular ramus of the lower jaw. The thickness and scope of soft nasopharyngeal tissues could be measured through the coronary section. Operators could observe the shape, border, inner echoes and the connection with the surrounding tissues of the tumors. Then a high-frequency detecting sensor was applied to examine the left and right neck, and to measure the tumescence of the lymph nodes.Results All the 4 patients showed 6 focuses. Among them, 2 cases had unilateral focuses; 2 cases had bilateral focuses. In all the focuses, there were 4 with moderate and low echoes; 2 with moderate echoes; 6 with substantial echoes and one had liquid without echoes, Sonograms showed that 4 cases developed with nasopharyngeal soft tissue thickened, 2 cases were found with nasopharyngeal tumour, and 4 cases with lymph tumescence on the neck detected on ultrasound.Conclusions Nasopharyngeal cancer can be detected via the neck on ultrasonography. The thickness of solt nasopharengeal tissues were increased and the tumor images could be visible. Ultrasound is useful for diagnosing lymph node metastasis from nasopharyngeal cancer.