鼻咽癌颅底侵犯的MRI

Skull Base Erosion in Nasopharyugeal Careinoma: Detection by MRI

目的 探讨鼻咽癌颅底侵犯的MRI表现形式及诊断价值。方法 选择经鼻咽部病理证实 ,并有明确颅底或颅神经受损症状的鼻咽癌患者 86例。经颅底及鼻咽部轴位T1WI,T2 WI和冠位、矢位T1WI扫描。 47例行增强后轴、冠、矢位T1WI扫描。结果 侵犯翼突者 5 6例 ,斜坡 5 4例 ,卵圆孔 (包括蝶骨大翼 ) 2 8例 ,岩尖 2 7例 ,枕骨 1例。71例有 2处以上联合病变。表现形式有 :①正常颅底骨皮质无信号带中断 ;②骨髓内T1高信号脂肪影被肿瘤信号代替 ;③骨内病灶强化 ;④穿过颅底神经孔的条状强化影。有颅内侵犯者 44例。结论 MRI是诊断鼻咽癌颅底侵犯的首选技术。

Objective To study MRI characteristics and value in the diagnosis of nasopharyngeal carcinoma with skull base erosion. Methods 86 cases of nasopharygeal carcinoma with positive nasopharyngeal pathology and symptoms of skull base erosion were selected. Axial T 1WI, T 2WI and coronal, sagital T 1WI were performed. 47 cases had axial, coronal and sagital T 1WI examination post Gd DTPA injection. Results Areas of skull base involvement were as follow: 56 cases with pterygoid process, 54 with clivus, 28 with foramen ovale (including sphenoid wing), 27 with petrous apex, 1 with occiptal bone. 71 cases had more than one area involvement. There are four patterns in our group: ①Defect in the signal avoid cortex of skull base; ②High signal intensity of marrow was replaced by tumor; ③Contrast enhancement in abnormal bone; ④String like enhancement passing nerve foramen in skull base. 44 cases included intracranial abnormal. Conclusion MRI is the preferred technique in dementstrating skull base involvemetn of nasopharyngeal carcinoman. [