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目的 :着重探讨鼻咽癌侵犯颈动脉间隙的MRI表现特征。方法 :回顾性分析经临床和病理证实的鼻咽癌侵犯颈动脉间隙MRI资料 2 8例。采用ElscientGyrexⅤ型MR机扫描。自旋回波序列 ,横断位 ,T1WI (4 40 /2 5ms) ,PDWI (2 2 0 0 / 2 0ms)和T2 WI (2 2 0 0 / 90ms)计 2 8例 ,冠状位 ,T1WI (4 40 / 2 5ms)计 8例 ,磁显葡胺MR增扫4例。结果 :(1)颈动脉间隙不对称 ,右侧 17例 ,左侧 8例 ,双侧 3例 ;(2 )颈内动脉和颈内静脉受压移位 16例 ,包裹缩窄 8例 ,不清 4例 ;(3)沿颈动脉间隙侵犯海绵窦 8例 ,侵犯口咽部 9例 ;(4 )咽后淋巴结肿大 ,单侧 8例 ,双侧 4例 ;(5 )颅底骨质破坏中 ,颈静脉孔受累 6例 ,蝶骨受累 5例 ,斜坡受累 3例 ;(6 )病变信号表现中 ,T1加权呈等信号 15例 ,低信号 7例 ,不均信号 6例 ;T2 加权呈高信号 2 3例 ,不均信号 5例 ;(7)MR增扫呈斑片状强化 4例 ;(8)腮腺向前推移 7例 ,头长肌不清 8例。结论 :鼻咽癌侵犯颈动脉间隙的部位、范围和类型等MRI表现特征 ,对临床放射治疗方案的实施 ,可提供重要影像信息。
Objective: To investigate the MRI features of nasopharyngeal carcinoma invading the carotid space. Methods :Retrospectively analyzed 28 cases of MRI data of cervical carcinomatous invasion confirmed by clinical and pathological nasopharyngeal carcinoma. Scans were performed using an Elscient Gyrex V MR machine. Spin echo sequence, transverse, T1WI (4 40 /2 5 ms), PDWI (2 0 0 / 2 0 ms) and T 2 WI (2 0 0 /90 ms) counts 28 cases, coronal, T1WI (4 40 / 2 5ms) 8 cases, magnetism significantly increased 4 cases of meglumine MR. Results: (1) Asymmetric carotid artery, 17 cases on the right side, 8 cases on the left side, 3 cases on both sides; (2) 16 cases of internal carotid artery and internal jugular vein compression displacement, 8 cases of parcel contraction, not 4 cases were cleared; (3) 8 cases of cavernous sinus were invaded along the carotid space and 9 cases were invaded by oropharynx; (4) pharyngeal lymph nodes were enlarged, unilateral in 8 cases and bilateral in 4 cases; (5) skull base bone mass In the destruction, there were 6 cases of jugular foramen involvement, 5 cases of sphenoid involvement, and 3 cases of slope involvement. (6) In the manifestation of lesions, T1 weighted showed 15 equal signals, 7 low signals, and 6 inhomogeneous signals; T2 weighted. There were 23 cases with high signal and 5 cases with inhomogeneous signal. (7) MR enhanced scan showed patchy enhancement in 4 cases; (8) parotid gland went forward in 7 cases, and head long muscle was unclear in 8 cases. Conclusion: The MRI features of NPC invading the carotid space, such as the location, scope and type, can provide important imaging information for the implementation of clinical radiation therapy.