鼻咽癌的MRI表现与鉴别诊断

MRI Performances and Differential Diagnosis of Nasophayngeal Carcinoma

目的:分析鼻咽Ca的MRI影像学特点,提高对该病的诊断及鉴别诊断水平。材料与方法:收集21例经穿刺活检诊断的鼻咽Ca,均作MRI平扫(T1WI/T2WI/STIR/DWI)及T1WI增强扫描。回顾性分析其MRI表现特点。结果:肿瘤病灶均表现为鼻咽部软组织肿块,主要起源于咽隐窝,其次是鼻咽侧壁及顶壁;大部呈等/稍长T1、等/稍长T2信号,STIR呈稍高信号,DWI呈高信号;少数肿块伴坏死;明显均匀或不均匀强化。肿瘤病灶多为条块状,呈浸润生长,患侧咽隐窝消失,咽鼓管咽口、咽鼓管圆枕变形,咽旁间隙外移。部分肿块向口咽腔、鼻后孔生长。可见头长肌、翼内肌等肌群受侵,颅底斜坡、岩椎等骨质破坏,颈部淋巴结肿大或转移。结论:鼻咽Ca的MRI影像特点鲜明,可作为其诊断依据。

Purpose:Analysis the characteristics of nasophayngeal carcinoma(NPC) MRI imaging,improve the level of diagnosis and differential diagnosis.Materials and Methods:Collect 21 cases of NPC proved by pathology,all cases undertake MRI scaN(T1WI/T2WI/STIR/DWI)and T1WI contrast enhanced.Analysis the MRI performances characteristics retrospectively.Results:Lesions are performances of nasophaynx soft tissue,mainly located in pharyngeal crypt,followed by nasophaynx side wall and top wall;most are iso-hyperintensity on T1WI and T2WI,slightly hyperintensity on STIR,hyperintensity on DWI;a few with necrosis;obvious uniform or non-uniform enhanced.Tumor lesions more like strip shaped;invasive growth;with lateral pharyngeal crypt disappear;eustachian tube swallow mouth,eustachian tube round pillow deformation;pharyngeal side clearance outward shift.Part of mase growth to oropharyngeal cavity and postnasal hole.Long head muscle、medial pterygoid and muscle groups invaded,skull base、petrous part bone destruction,neck lymph node enlargement or metastasis can be found.Conclusion:The MRI imagings of nasophayngeal carcinoma(NPC) have characteristic,can be used as a basis of diagnosis.