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目的比较MRI与CT对鼻咽癌局部侵犯的检测差异及其对鼻咽癌T分期的影响。方法 2007年1月至2009年1月,华中科技大学同济医学院附属荆州医院病理确诊的鼻咽癌患者68例,放疗前5 d内以同一固定体位,完成增强CT和增强MRI。在CT和MRI上分别读片判定鼻咽癌局部侵犯范围和T分期。结果 MRI对鼻咽癌侵及头长肌、咽旁间隙、颈动脉鞘区、咽后淋巴结、颅底骨质、海绵窦和颅内的检出率分别为82.4%、85.3%、39.7%、48.5%、54.2%和20.6%,CT的检出率分别为58.8%、70.6%、17.6%、17.6%、29.4%和5.9%,P<0.05,差异有统计学意义;而MRI和CT对鼻咽癌侵犯鼻咽壁、鼻腔、口咽、副鼻窦的检出率比较,差异无统计学意义(P>0.05)。有21例(30.9%)T分期发生改变。结论与CT比较,MRI在鼻咽癌诊断上的优势主要表现在发现咽后淋巴结、头长肌、颈动脉鞘区、颅底骨质、海绵窦和颅内的病灶。MRI可使患者T分期升级。
Objective To compare the difference between MRI and CT in the detection of local invasion of nasopharyngeal carcinoma and its influence on the T stage of nasopharyngeal carcinoma. Methods From January 2007 to January 2009, 68 patients with nasopharyngeal carcinoma confirmed by pathology in Jingzhou Hospital of Tongji Medical College of Huazhong University of Science and Technology were enrolled. The same fixed position was performed within 5 days before radiotherapy. CT and MRI were completed. On CT and MRI were read on film to determine the extent of local violations of nasopharyngeal carcinoma and T staging. Results The detection rates of MRI on nasopharyngeal carcinoma (NPC), head space, parapharyngeal space, carotid sheath, posterior pharyngeal lymph nodes, skull base bone, cavernous sinus and intracranial were 82.4%, 85.3%, 39.7% 48.5%, 54.2% and 20.6% respectively. The detection rates of CT were 58.8%, 70.6%, 17.6%, 17.6%, 29.4% and 5.9% respectively, with significant difference The detection rate of nasopharyngeal wall, nasal cavity, oropharyngeal and paranasal sinuses in pharyngeal carcinoma was no significant difference (P> 0.05). 21 cases (30.9%) T staging changed. Conclusion Compared with CT, MRI in the diagnosis of nasopharyngeal cancer mainly in the discovery of retropharyngeal lymph nodes, long hair, carotid sheath, skull base, cavernous sinus and intracranial lesions. MRI can upgrade the patient T staging.