中华放射学杂志
中華放射學雜誌
중화방사학잡지
Chinese Journal of Radiology
2010年
10期
1024-1029
,共6页
陈韵彬%方燕红%陈英%卢涛%蔡林峰%廖江%陈加优%胡春淼%郑德春%肖友平%潘建基
陳韻彬%方燕紅%陳英%盧濤%蔡林峰%廖江%陳加優%鬍春淼%鄭德春%肖友平%潘建基
진운빈%방연홍%진영%로도%채림봉%료강%진가우%호춘묘%정덕춘%초우평%반건기
鼻咽肿瘤%磁共振成像%肿瘤分期
鼻嚥腫瘤%磁共振成像%腫瘤分期
비인종류%자공진성상%종류분기
Nasopharyngeal neoplasms%Magnetic resonance imaging%Neoplasm staging
目的 应用MRI探讨鼻咽癌侵犯周围结构的规律及其与肿瘤T分期的关系.方法 回顾性分析1573例经病理证实的鼻咽癌初诊患者,根据2008年鼻咽癌T分期,观察鼻咽癌向周围结构侵犯的MRI表现和规律.对鼻咽癌周围不同方向结构的侵犯率均采用Z检验分析.结果 鼻咽癌对周围结构的侵犯:咽颅底筋膜1299例(82.58%)、咽旁间隙1090例(69.29%)、鼻腔304例(19.33%)、口咽49例(3.12%)、颈动脉间隙514例(32.68%)、翼内肌661例(42.02%)、翼外肌210例(13.35%)、颅底骨质943例(59.95%)、颅神经630例(40.05%)、鼻窦242例(15.38%).T分期分布:T1期为242例(15.38%),T2期为288例(18.31%),T3期为410例(26.06%),T4期为633例(40.24%).鼻腔受累的病例中90.46%(275/304)合并T3以上的结构受累;口咽受累均伴有T3以上结构受累;翼内肌受累的病例中69.14%(457/661)伴有T4结构侵犯;鼻窦受累的病例中92.15%(223/242)伴有T4结构侵犯.鼻咽癌侵犯周围结构的模式为向侧方(1299例)多于向上(943例)侵犯(Z=14.025,P＜0.01);向侧方侵犯多于向下(49例)(Z=45.032,P＜0.01);向上侵犯多于向下(Z=34.301,P＜0.01);向前侵犯(304例)多于向下(Z=14.404,P＜0.01).结论 鼻咽癌侵犯周围结构的模式为向侧方侵犯多于向上;向侧方侵犯多于向下;向上侵犯多于向下;向前侵犯多于向下.
目的 應用MRI探討鼻嚥癌侵犯週圍結構的規律及其與腫瘤T分期的關繫.方法 迴顧性分析1573例經病理證實的鼻嚥癌初診患者,根據2008年鼻嚥癌T分期,觀察鼻嚥癌嚮週圍結構侵犯的MRI錶現和規律.對鼻嚥癌週圍不同方嚮結構的侵犯率均採用Z檢驗分析.結果 鼻嚥癌對週圍結構的侵犯:嚥顱底觔膜1299例(82.58%)、嚥徬間隙1090例(69.29%)、鼻腔304例(19.33%)、口嚥49例(3.12%)、頸動脈間隙514例(32.68%)、翼內肌661例(42.02%)、翼外肌210例(13.35%)、顱底骨質943例(59.95%)、顱神經630例(40.05%)、鼻竇242例(15.38%).T分期分佈:T1期為242例(15.38%),T2期為288例(18.31%),T3期為410例(26.06%),T4期為633例(40.24%).鼻腔受纍的病例中90.46%(275/304)閤併T3以上的結構受纍;口嚥受纍均伴有T3以上結構受纍;翼內肌受纍的病例中69.14%(457/661)伴有T4結構侵犯;鼻竇受纍的病例中92.15%(223/242)伴有T4結構侵犯.鼻嚥癌侵犯週圍結構的模式為嚮側方(1299例)多于嚮上(943例)侵犯(Z=14.025,P＜0.01);嚮側方侵犯多于嚮下(49例)(Z=45.032,P＜0.01);嚮上侵犯多于嚮下(Z=34.301,P＜0.01);嚮前侵犯(304例)多于嚮下(Z=14.404,P＜0.01).結論 鼻嚥癌侵犯週圍結構的模式為嚮側方侵犯多于嚮上;嚮側方侵犯多于嚮下;嚮上侵犯多于嚮下;嚮前侵犯多于嚮下.
목적 응용MRI탐토비인암침범주위결구적규률급기여종류T분기적관계.방법 회고성분석1573례경병리증실적비인암초진환자,근거2008년비인암T분기,관찰비인암향주위결구침범적MRI표현화규률.대비인암주위불동방향결구적침범솔균채용Z검험분석.결과 비인암대주위결구적침범:인로저근막1299례(82.58%)、인방간극1090례(69.29%)、비강304례(19.33%)、구인49례(3.12%)、경동맥간극514례(32.68%)、익내기661례(42.02%)、익외기210례(13.35%)、로저골질943례(59.95%)、로신경630례(40.05%)、비두242례(15.38%).T분기분포:T1기위242례(15.38%),T2기위288례(18.31%),T3기위410례(26.06%),T4기위633례(40.24%).비강수루적병례중90.46%(275/304)합병T3이상적결구수루;구인수루균반유T3이상결구수루;익내기수루적병례중69.14%(457/661)반유T4결구침범;비두수루적병례중92.15%(223/242)반유T4결구침범.비인암침범주위결구적모식위향측방(1299례)다우향상(943례)침범(Z=14.025,P＜0.01);향측방침범다우향하(49례)(Z=45.032,P＜0.01);향상침범다우향하(Z=34.301,P＜0.01);향전침범(304례)다우향하(Z=14.404,P＜0.01).결론 비인암침범주위결구적모식위향측방침범다우향상;향측방침범다우향하;향상침범다우향하;향전침범다우향하.
Objective To investigate the peri-nasopharyngeal invasion patterns of nasopharyngeal carcinoma (NPC) on MRI and its relationship with tumor staging. Methods One thousand five hundred and seventy-three patients with newly diagnosed NPC which were histo-pathologically proved were retrospectively studied. The MRI manifestations and invasion patterns of the NPCs were elevated according to the 2008 Tstaging system of NPC. Z test was used to analyze the rate of adjacent structures invasion in NPCs. Results The structures invaded by NPCs included pharyngobasilar fascia in 1299 cases (82. 58% ); parapharyngeal space, 1090 ( 69. 29% ); nasal cavities, 304 ( 19. 33% ); oropharynx, 49 ( 3. 12% ); carotid space,514(32. 68% ); medial pterygoid muscle, 661 (42. 02% ); lateral pterygoid muscle, 210( 13. 35% ); skull base bones, 943(59. 95% ); cranial nerves, 630(40. 05% ) and paranasal sinuses, 242 ( 15.38% ). The T-stage distribution was T1, 242 cases ( 15.38% ); T2, 288 ( 18. 31% ); T3, 410 (26. 06% ) and T4,633 (40. 24% ). Among the cases with nasal cavities invasion, 90. 46% (275/304)showed the involvement of the structures seen in T3 or T4 stage, which was found in all cases with oropharynx invasion. In addition,69. 14% (457/661) of cases with medial pterygoid muscle invasion and 92. 15% (223/242) of cases with paranasal sinuses invasion showed the involvement of structures seen in T4 stage. As for the invasion patterns of NPC, the lateral invasion of pharyngobasilar fascia was more frequent than upward invasion of skull base (Z = 14. 025, P ＜ 0. 01 ) and downward invasion of oropharynx ( Z = 45.032, P ＜ 0. 01 ), and the downward invasion of oropharynx was less frequent than upward invasion of skull base ( Z = 34. 301, P ＜ 0. 01 ) and forward invasion of nasal cavities ( Z = 14. 404, P ＜ 0. 01 ). Conclusion NPC has a predilection of lateral invasion rather than upward and downward invasion, and its upward and forward invasion are more common than downward invasion.
