56例鼻咽癌侵犯副鼻窦的MR影像分析

Study of MR image for involvement of paranasal sinuses in 56 patients with nasopharyngeal carcinoma

目的分析鼻咽癌侵犯副鼻窦的核磁共振（MR）特点。方法回顾分析2003年12月-2004年8月收治的首诊鼻咽癌并副鼻窦侵犯的56例患者MR表现。结果MR表现为窦壁破坏100％，窦内黏膜增粗51．8％，腔内占位64．3％，侵犯病灶与鼻咽肿瘤相连98．2％，合并积液25％。在扫描技术上，横断位、冠状位及矢状位诊断阳性率分别为66．1％、76．8％和98．2％（P〈0．000），而TIW1，T2W2在60％左右，增强扫描则高达100％（P〈0．000）。结论窦壁连续性中断、不完整；窦腔黏膜不均匀性增厚；窦腔内肿物与鼻咽肿瘤主体相连，有相同程度的强化；在T1W1呈等或略低信号，在T2W1为略高或等信号；增强扫描明显强化，是诊断副鼻窦受侵犯的要点。MR的矢状位及增强扫描有助于副鼻窦侵犯的诊断。

Objective To study the nuclear magnetic resonance image feature for involvement of paranasal sinuses in patients with nasopharyngeal carcinoma. Methods The MRI of 56 patients with NPC and paranasal sinuses infringed were evaluated between December 2003 and August 2004. Results Among them, 56 （ 100% ） showed breakage in the wall of paranasa sinuses, 29 （ 51. 8% ） had thick mucous membrane in sinuses, 36 （64.3%） showed tumour invasion sinuses, 55 （ 98.2% ） connected primary carcinoma with the lesion, and 14 （25%）stored up fluid in sinuses. On MRI scan technique,the positive ratio of diagnoses were 66.1% ,76.8% and 98.2% respectively（ P 〈 0.000）in the arial section, coronal section and sagittal section. And nearly 60% in the T1W1 and T2W1 ,but 100% in strengthen scan. Conclusions The finding of sinuses wall breakage;thick mucous membrane in sinuses ;tumour invasion cavity connective mass, and same enhancement signal in MR image may indicate the paranasal sinuses involved by primary tumour. The sagittal section and enhanced MRI scan are helpful to diagnose.