增强CT冠状扫描在诊断鼻咽癌颅底侵犯中的意义

The Significance of Enhanced CT Coronal Scan in Diagnosis of Skull Base Invasion by Nasopharyngeal Carcinoma

目的:探讨鼻咽部增强CT冠状位扫描对诊断鼻咽癌侵犯颅底的价值。方法:将经病理学检验证实的193例鼻咽癌的CT增强轴位扫描与冠状位扫描颅底情况进行回顾性对照分析。结果:193例鼻咽癌中,120例(占62.2％)经两种扫描均未见颅底侵犯;10例(5 2％)轴位扫描末见颅底异常而经冠状扫描发现其受侵犯;15例(7.8％)轴位可疑颅底受侵犯而经冠状扫描肯定侵犯11例,排除4例;轴位扫描显示海绵受窦侵有26例,增强CT冠状扫描则为3例。结论:增强CT冠状扫描对确定鼻咽癌有无颅底骨质侵犯及其侵犯部位、范围与程度均有再要价值,在显示海绵窦受侵犯、肿瘤组织沿脑池或/和脑沟等蛛网膜下腔生长,侵犯周围组织的征像方面,明显优于轴位扫描。

Objective: To evaluate the role of enhanced CT coronal scan in diagnosis of skull base invasion by nasopharyngeal carcinoma (NPC) .Methods: The enhanced CT axial and coronal scans of 193 cases of histopathologieally proved NPC were retrospectively analyzed for status o{ skull base invasion.Results: Among the 193 cases of NPC, 120(62.2% ) were not shown lo have skull base invasion on both scans; 10(5 .2% )cases which had no evidence of skull base abnormality on axial scan were shown to have skull base invasion on coronal scan.For 15 cases(7.8% )with suspected skull base invasion shown by axial scan,11 were confirmed and 4 excluded by coronal scan.The invasion of cavernous sinus was displayed in 26 cases by axial scan and 38 cases by coronal scan. Conclusion: Enhanced CT coronal scan plays an important role in detection of skull base invasion, the site and extent as well as degree of invasion for patients with NPC. It is superior to axial scan in demonstrating cavernous sinus invasion, tumor growth through the cistern, sulcus and subarachnoid space .