CAJ | 학술논문

目的探讨MRI影像学特征对鼻咽癌放疗后局部复发或残留的评估价值.方法鼻咽癌放疗后3个月-3年复查MRI诊断残留或复发患者47例,其中38例经病理证实为复发或残留.所有病例均行鼻咽颅底及颈部的MRI轴位T1WI、T2WI、SPIR,以及GD-DTPA增强扫描后T1WI轴位、矢状位扫描.在不同序列MRI图像上观察有无复发或残留肿瘤.结果本组38例MRI与病理诊断符合,其中鼻咽腔肿块21例,鼻咽腔外肿块17例；假阳性9例；诊断准确性为80.9％.鼻咽腔外肿块发生在咽旁间隙肿块11例,颅底骨质破坏8例,海绵窦受侵犯4例,眼眶受侵犯2例,副鼻窦及鼻腔侵犯5例,颅内侵犯3例.MRI增强扫描可见复发或残留处肿块呈明显强化.结论鼻咽癌放疗后局部残留或复发的原因多种多样,病变形态多样,侵及范围广；MRI增强扫描对评估鼻咽癌复发或残留具有重要价值,是鼻咽癌放疗后疗效判断重要的检查手段.
목적 탐토MRI영상학특정대비인암방료후국부복발혹잔류적평고개치.방법 비인암방료후3개월-3년복사MRI진단잔류혹복발환자47례,기중38례경병리증실위복발혹잔류.소유병례균행비인로저급경부적MRI축위T1WI、T2WI、SPIR,이급GD-DTPA증강소묘후T1WI축위、시상위소묘.재불동서렬MRI도상상관찰유무복발혹잔류종류.결과 본조38례MRI여병리진단부합,기중비인강종괴21례,비인강외종괴17례；가양성9례；진단준학성위80.9％.비인강외종괴발생재인방간극종괴11례,로저골질파배8례,해면두수침범4례,안광수침범2례,부비두급비강침범5례,로내침범3례.MRI증강소묘가견복발혹잔류처종괴정명현강화.결론비인암방료후국부잔류혹복발적원인다충다양,병변형태다양,침급범위엄；MRI증강소묘대평고비인암복발혹잔류구유중요개치,시비인암방료후료효판단중요적검사수단.
Objective To explore the value of MRI in the detection of local recurences or residues of nasopharyngeal carcinoma after radiotherapy.Methods 47 patients were diagnosed as local recurences or residues by MRI 3 months to 3 years after radiotherapy.38 of the patients were confirmed by pathological examination.All the patients underwent MRI scans for nasopharynx,skull base and neck with axial T1WI,T2WI,and SPIR,and GD-DTPA enhanced T1WI axial and sagittal scans.MRI images in different sequences were observed to identify recurrent or residual tumors.Results MRI diagnosis matched the pathological diagnosis in all the patients.21 patients were diagnosed as nasal cavity masses,17 nasopharyngeal masses,and 9 had false positive results; with a diagnostic accuracy of 80.9％.Nasopharyngeal cavity masses orginated from parapharyngeal space occurred in 11 patients,destruction of skull base bone in 8,cavernous sinus invasion in 4,orbital invasion in 2,paranasal and nasal invasion in 5,and intracranial invasion in 3.Enhanced MRI scans revealed significant enhancement in the recurrent or residual masses.Conclusions The causes and shapes of local recurences or residues are varied and the lesions have a wide range of invasion.Enhanced MRI scan has a significant value in detection of recurrent or residual nasopharyngeal carcinoma and is the most important approach in assessing the efficacy of radiotherapy.