MRI与CT对鼻咽癌局部侵犯检测差异的对比分析

The comparative analysis of CT versus MRI on detecting the local invasion of nasopharyngeal carcinoma

目的比较MRI与CT对鼻咽癌局部侵犯的检测差异及其对鼻咽癌T分期的影响。方法 2007年1月至2009年1月,华中科技大学同济医学院附属荆州医院病理确诊的鼻咽癌患者68例,放疗前5 d内以同一固定体位,完成增强CT和增强MRI。在CT和MRI上分别读片判定鼻咽癌局部侵犯范围和T分期。结果 MRI对鼻咽癌侵及头长肌、咽旁间隙、颈动脉鞘区、咽后淋巴结、颅底骨质、海绵窦和颅内的检出率分别为82.4%、85.3%、39.7%、48.5%、54.2%和20.6%,CT的检出率分别为58.8%、70.6%、17.6%、17.6%、29.4%和5.9%,P<0.05,差异有统计学意义;而MRI和CT对鼻咽癌侵犯鼻咽壁、鼻腔、口咽、副鼻窦的检出率比较,差异无统计学意义(P>0.05)。有21例(30.9%)T分期发生改变。结论与CT比较,MRI在鼻咽癌诊断上的优势主要表现在发现咽后淋巴结、头长肌、颈动脉鞘区、颅底骨质、海绵窦和颅内的病灶。MRI可使患者T分期升级。

Objective To compare the differences between CT and MRI on detecting the local invasion of nasopharyngeal carcinoma.Methods Sixty-eight cases with nasopharyngeal carcinoma whith were pathologically proved and were enrolled into this study from January 2007 to January 2009.These cases performed enhanced CT and MRI in five days before radiotherapy,the detective rate of every anatomical position and T staging were analyzed by these two kinds of imaging methods.Results The incidence rates of longus scapitis,parapharyngeal space,carotid sheath,retropharyngeal lymph nodes,skull base and cavernous sinus encroachment diagnosed by CT and MRI were 82.4%,85.3%,39.7%,48.5%,54.2%,20.6% and 58.8%,70.6%,17.6%,17.6%,29.4%,5.9%（P0.05） respectively,with statistical significance.The incidence rates of nasopharyngeal wall,nasal cavity,oropharynx and accessory sinus encroachment diagnosed by CT and MRI had not statistical significance.There were changs in 21 cases（30.9%） T staging.Conclusion The detecting rates of longus scapitis,retropharyngeal lymph nodes,carotid sheath,skull base and cavernous sinus encroachment detected by MRI are higher than those by CT.MRI can elevate the T staging for nasopharyngeal carcinoma.