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目的 探讨鼻咽癌颅底骨受累与头痛和颅神经症状的关系。方法 对经病理证实行首程放射治疗并做MRI检查的鼻咽癌患者 12 8例 ,通过MRI检查结果分析鼻咽癌颅底骨受累与头痛和颅神经症状的关系 ,并推断其发生时间。结果 鼻咽癌颅底骨受累的发生率为 75 .8% (97 12 8) ,破坏部位以斜坡最为常见 ,占 81.4% (79 97) ,破坏的斜坡脑面出现硬膜强化增厚 (硬膜尾征 )占 16 .4%(2 1 12 8) ,6例放射治疗后 0～ 14个月复查MRI,强化增厚的硬膜全部恢复正常或明显变薄。头痛发生率为 5 7.0 % (73 12 8) ,以颞、额部最为常见 ,占 5 6 .2 % (4 1 73) ;颅神经症状阳性率为 41.4% (5 3 12 8) ,以第Ⅴ对最为常见 ,占 84.9% (4 5 5 3)。头痛、颅神经症状阳性及两者均出现的颅底骨受累发生率分别为 94.5 % (6 9 73) ,92 .5 % (4 9 5 3) ,97.6 % (4 1 42 )。在颅底骨受累的病例中 ,头痛、颅神经阳性及两者均出现者分别占 71.1% (6 9 97) ,5 0 .5 % (4 9 97) ,42 .3 % (4 1 97)。上述两类症状出现 2个月以上者颅底骨 10 0 .0 % (35 35 ,13 13)受累 ,无症状的颅底骨受累发生率为 45 .5 % (2 0 44 )。结论 头痛和颅神经症状可能是鼻咽癌颅底骨受累的重要指征
Objective To investigate the relationship between skull base involvement and headache and cranial nerve symptoms in nasopharyngeal carcinoma. Methods One hundred and eighty-eight patients with nasopharyngeal carcinoma who underwent radiotherapy for the first time by pathology and MRI were analyzed. The relationship between cranial basement skull involvement and headache and cranial nerve symptoms of nasopharyngeal carcinoma was analyzed by MRI and the time of onset was estimated. Results The incidence of cranial basement skull involvement in nasopharyngeal carcinoma was 75.8% (97 12 8). The most common part of the lesions were slopes, accounting for 81.4% (79 97). Hard degeneration Membranous sign) accounted for 16.4% (2 1 12 8). Six patients underwent repeat MRI from 0 to 14 months after radiotherapy. The thickening of the dura mater returned to normal or became significantly thinner. The incidence of headache was 5 7.0% (73 12 8), with temporal and forehead being the most common, accounting for 56.2% (41.73). The positive rate of cranial nerve symptoms was 41.4% (5 3 12 8) V is the most common, accounting for 84.9% (453). Headaches, cranial neuropathies, and cranial basement involvement occurred in 94.5% (69.3%), 92.5% (495%) and 97.6% (4142%), respectively. Among the cases of skull base involvement, headache, cranial nerves and both were 71.1% (69.7%), 50.5% (497%), 42.3% (4197%), . The above two types of symptoms occurred more than 2 months in the skull base 100.0% (35 35, 13 13) involvement, asymptomatic skull base involvement was 45.5% (2044). Conclusion Headache and cranial nerve symptoms may be an important indication for the involvement of skull base in nasopharyngeal carcinoma