506例鼻咽癌放疗前CT图像分析

CT Evaluation of 506 Cases with Nasopharyngeal Carcinoma before Radiotherapy

目的 :探讨鼻咽癌咽旁间隙浸润程度与颈淋巴结转移、颈动脉鞘受浸及颅底骨质破坏的关系。方法 :对 5 0 6例鼻咽癌放疗前CT图像分析 ,采用Sham等三线法将咽旁间隙浸润程度分为 :“0”、“Ⅰ”、“Ⅱ”、“Ⅲ” (无、轻、中、重 ) 4级。结果 :咽旁间隙受侵 413例 (81 6 2 % )、颈淋巴结转移 30 5例 (6 0 2 7% )、颈动脉鞘受累 2 42例 (47 82 % )、颅底骨质破坏 115例 (2 2 72 % )。结论 :颈淋巴结转移与咽旁间隙受累有关 ,但与其浸润程度无关 ;颈动脉鞘受侵与咽旁间隙受累有关 ,也与其浸润程度有关 ;颅底骨质破坏与咽旁间隙重度浸润有关 ,而与轻。

Objective: To analyse the relationships among the degrees of parapharyngeal space(PPS)extension and cervical lymphnode metastases,carotid sheath involvement,basal skull erosion.Method:CT scan was performed before radiotherapy on 506 patients with pathologically proved NPC.According to the method proposed by Sham et al,the degrees of PPS infiltration were described as:0(no extension),Ⅰ(mild extension),Ⅱ(moderate extension)and Ⅲ(severe extension).Result:The PPS extension was found in 413 cases(81 62%);cervical lymphnode metastases in 305s(60 27%);carotid sheath involvement in 242s(47 82%),and basal skull erosion in 115s (22 72%). Conclusion:The cervcal lymphnode metastasis is correlated to the PPS extension,but is not correlated to the degrees of the PPS infiltration.The carotid sheath involvement is correlated to either the PPS extension or the degrees of the infiltration.The basal skull erosion is correlated to the extensive of PPS extension,but is not related with the mild and moderate extension.