鼻咽癌局部侵犯的CT与MRI对比研究:附283例分析

Comparison of CT and MRI in the detection of primary tumor extension of nasopharyngeal carcinoma: analysis of 283 cases

目的比较CT与MRI在检测鼻咽癌局部病灶侵犯范围的差异。方法收集经病理证实、同时有治疗前鼻咽部的增强螺旋CT与MRI资料的初诊鼻咽癌283例。由两名放射学专家分别进行CT与MRI的阅片,采用χ2检验比较CT与MRI检测各部位受侵的发生率。结果MRI显示软组织超腔侵犯和咽后淋巴结的转移率分别为95.1%和74.6%,均明显高于CT的90.5%和65.0%(P分别为0.035和0.013)。MRI上颅底骨质及通颅孔道受侵的发生率分别为44.2%和39.6%,均明显高于CT的29.0%和18.7%(P值均小于0.001)。MRI上颅内及海绵窦的侵犯率为17.3%,明显高于CT的5.7%(P<0.001)。结论MRI对于鼻咽癌软组织超腔侵犯、颅底骨质及通颅孔道侵犯、海绵窦及颅内侵犯以及咽后淋巴结转移的检出率均明显优于CT。

Objective To investigate the ability of computerized tomography （CT） versus magnetic resonance imaging （MRI） in detecting the extension of primary tumor of nasopharyngeal carcinoma （NPC）. Methods Two hundred and eighty three cases of primary NPC, histologically diagnosed and received enhanced spiral CT and MRI scans of nasopharynx were enrolled in this study. CT and MR images were analyzed by two radiologists in consensus. Chi square test was used to corn pare the difference in detecting the involvement of each local site of NPC by method of CT and MRI. Results MRI appeared to be superior to CT in the detection of primary tumor extension to soft tissue of extra-0nasopharynx cavity （95. 1% vs 90.5%, P=0.035）, retropharyngeal lymphadenopathy （74.6% vs 65.0%. P=0.013）, bone invasion （44.2% vs29.0%, P〈0.001）, foramen in the skull base （39. 6% vs 18. 7%, P〈0. 001） and cavernous sinus or intracranial infiltration （17.3% vs 5.7%, P〈0. 001）, respectively. Conclusion Comparing with contrast enhanced spiral CT, MRI has remarka ble advantage in detecting of invasion of soft tissue of extra-nasopharyngx cavity, base of skull or foramen in it, cavernous si nus or intracranial, and retropharyngeal lymphoadenopathy of NPC.