头颈部放疗后软组织损伤的CT表现

CT findings of soft tissue injury following head and neck radiation

目的 :本文旨在观察和探讨头颈部肿瘤放疗后软组织损伤的CT表现 ,以提高对头颈部放射性损伤的影像学认识。方法 :对头颈部恶性肿瘤放疗后 70例作CT扫描观察 ,计 13 3次扫描 ,扫描 1次 3 8例 ,2次 15例 ,3次以上 17例。观察时间分为放疗后近期 ( 6个月以内 )、中期 ( 6～ 12个月 )和远期 ( 12个月以上 )。放疗剂量为 40～ 72Gy(单程放疗 )、14 0Gy(二程及二程以上放疗 )。全部病例均有放疗前CT图像对照。结果 :CT所见包括皮下脂肪层变薄 2 6例 ,皮肤增厚15例 ,皮肤凹陷 2 6例 ,肌肉萎缩 19例 ,颈深筋膜增厚 15例 ,皮下纤维性增生 18例 ,涎腺萎缩 19例 ,复发性肿瘤 18例。结论 :CT对头颈部软组织放射性损伤的表现和程度的判断是准确的 。

Objective:To improve the understanding of CT features of soft tissue injury after head and neck radiation.Methods:133 times of CT scanning were performed in 70 patients with malignancies of head and neck after irradiation.The patients had received radiation dose about 40～72 Gy (multiple course) and 140 Gy(multiple-course).38 cases had once CT scan,15 cases had two times scanning and more than three times scanning had been performed in 17 cases after radiation.All patients had CT scans both before and after radiation.The periods of observation were divided into short-term (<6 months),mid-term (6～12 months) and long-term (>12 months) after irradiation.Results:CT findings included skin thickening (15 cases),thinning of subcutaneous fat (26 cases),skin excavation (26 cases),muscular atrophy (19 cases),thickening of deep cervical fascia (15 cases),subcutanous fibrous proliferation (18 cases),salivary gland atrophy (18 cases),and tumor recurrence (18 cases).Conclusions:CT can well demonstrate the feature,location and degree of soft tissue injury after head and neck radiation,which may give reference to clinical treatment.