鼻咽癌颅底骨质侵犯的MRI评价

Nasopharyngeal Carcinoma Involved Basicranial Bone: Evaluated with MR Imaging

目的:评价M RI检查对鼻咽癌侵犯骨质的诊断价值及其对肿瘤分期的影响。方法:回顾性分析本院350例初诊鼻咽癌患者的M RI影像资料,其中有颅底骨质侵犯196例,病理类型以鳞癌为主180例。134例采用PhilipsT5-II型超导磁共振成像仪,场强0.5T。62例采用Philips intera型超导磁共振成像仪,场强1.5T。8例单纯平扫,188例平扫后增强,造影剂为Gd-DTPA,剂量为0.1m m ol/kg体重,经前臂静脉注射。结果:196例有骨质侵犯的初诊鼻咽癌中,单部位侵犯65例(33.16%),多部位侵犯131例(66.83%)。单侧侵犯178例(90.81%),双侧侵犯18例(9.19%)。累计骨质破坏部位698个,骨质侵犯类型:骨质硬化型13个部位(1.86%),骨髓浸润型120个部位(17.19%),溶骨性破坏565个部位(80.95%)。结论:M RI可作为评价鼻咽癌颅底骨质侵犯首选检查方法,尤其在评价鼻咽癌早期骨髓侵犯方面M RI比CT敏感,M RI检查可增加鼻咽癌分期的准确性。

Objective: To evaluate diagnostic value of MR imaging detecting nasopharyngeal carcinoma(NPC) involved basicranial bone. Methods: Reviewed and analyzed MRI material of 350 cases NPC at first visited, detected basicranial bone erosion in 196 cases. All cases were proved to be NPC by pathology. The main pathologic type is squama carcinoma, There were 180 squama carcinoma in 196 cases. The MR images of 134 patients with NPC were obtained on 0.5T unit, 62 patients on 1.5T unit. The head coil was used. Only unenhanced scan was in 8 case of 196 cases. There were 188 cases with enhanced scan by intravenous injection Gd-DTPA (0.1mmol/kg) after unenhanced scan. Results: In 196 cases with NPC involved basicranial bone,there were 178 cases (90.81%) in unilateral basicranial bone erosion, 18 cases (9.19%) in bilateral basicranial bone erosion. There were 65 cases with single site involved and 131 cases with muti-sites involved. Total involved sites were 698 sites. The patterns and frequencies of bone erosion were as follows: osteosclerosis 13 sites (1.86%), osteolysis 565 site (80.95%), marrow erosion 120 sites (17.19%). Conclusion: MR imaging is a preferred method in evaluating nasopharyngeal carcinoma invasion basicranial bone. MR imaging is more sensitive than CT especially in detecting NPC invasion marrow.