69例鼻咽癌侵犯颅面部解剖结构的CT影像分析

CT analysis of 69 patients with nasopharyngeal carcinoma invading the Cranio-maxillofacial structures XIE

目的:采用CT影像分析鼻咽癌对颅面部组织的侵袭特点。方法:分析69例鼻咽癌首次放疗前的CT影像,分别统计其向前方(包括翼板、翼腭窝、上颌窦、筛窦、鼻腔)、外侧方(包括腭肌、咽旁间隙、颈鞘、颞下窝)、内侧方(鼻咽腔、对侧鼻咽)、后方(包括椎前肌、颈椎、斜坡)、上方(包括蝶窦、破裂孔、卵圆孔、蝶骨大翼、岩尖、颅内)、下方(口咽侧壁、口咽旁间隙、软腭、硬腭)侵犯的比例。结果:本组向前侵犯18例,占26.1%;向外侧侵犯53例,占76.8%;向内侧侵犯31例,占44.9%;向后侵犯32例,占46.4%;向上侵犯14例,占20.3%;向下侵犯29例,占42.0%。结论:向外侧方侵犯是鼻咽癌最常见的侵犯方向,其次是向后方侵犯,其后依次是内侧方、下方、前方、上方。

PURPOSE:To analyze the characteristics of involvement of surrounding tissues in nasopharyngeal carcinoma(NPC). METHODS: CT images of 69 cases with preradiotherapeutic nasopharyngeal carcinoma were analyzed to calculate the rates of anterior spread(including pterygoid plates,pterygopalatine fossa,maxillary sinus,ethmoidal sinus, nasal cavity),lateral spread(including palatal muscle, parapharyngeal space,carotid sheath and infratemporal fossa),medial spread(including pharyngeal cavity,the contralateral side of the nasopharynx),posterior spread(including prevertebral muscle, cervical vertebra and clivus),superior spread(including sphenoidal sinus,foramen lacerum, foramen ovale ,greater wing of sphenoid bone,petrous apex and intracranial region), inferior spread(including oropharynx,parapharyngeal space,soft palate,hard palate) respectively. RESULTS: 18 cases of in this series had anterior spread(26.1%);53 had lateral spread(76.8%);31 had medial spread(44.9%);32 had posterior spread(46.4%);14 had superior spread(20.3%);29 had inferior spread(42.0%). CONCLUSIONS: Lateral spread is the most common spread direction in nasopharyngeal carcinoma,followed by posterior spread,median spread,inferior spread , anterior spread,superior spread in turn.