MSCT增强扫描及多平面重建对判断鼻咽癌颈动脉鞘区侵犯价值.docVIP

MSCT增强扫描及多平面重建对判断鼻咽癌颈动脉鞘区侵犯价值 　 作者：龙农 李庆 王志强 谭华绣 【摘要】 目的 探讨MSCT增强扫描及其多平面重建技术对判断鼻咽癌颈动脉鞘区侵犯的价值。方法 将病理学检验证实的102例鼻咽癌的MSCT平扫、增强及多平面重建的颈动脉鞘区情况进行回顾性对照分析。结果 平扫显示颈动脉鞘区部分侵犯68例（66.7％），显示肿物占据11例（10.8％）；而MSCT增强扫描及其多平面重建显示颈动脉鞘区部分侵犯46例（45.1％），肿物占据33例（32.4％），经统计学检查两者的差异有显著性（P＜0.05）。结论 MSCT增强扫描及其多平面重建技术可以区分颈动脉鞘区是部分侵犯还是肿物占据，因而较MSCT平扫能更准确划分肿瘤的侵犯范围，可以提高鼻咽癌临床分期的准确性。 【关键词】 鼻咽肿瘤 颈动脉鞘区 肿瘤侵犯 多层螺旋CT 【Abstract】 Objective To probe into the technology of MSCT contrast enhancement scanning and Multiplanar reformation which judge nasopharyngeal carcinoma carotid sheath area whiplash being infringed.Methods 102 cases of nasopharyngeal carcinoma which were verified by pathology were reviewed and analyzed.Results Plain scanning showed 68 cases of whiplash district of carotid sheath area being infringed(account for 66.7%) and 11 cases of mass occupied (account for 10.8%).But MSCT contrast enhancement and Multiplanar reformation showed 46 cases of whiplash district of carotid sheath area being infringed (account for 45.1%)，33 cases of mass occupied (account for 32.4%)，which had significance meaning through checking the difference between them by statistics (Plt;0.05).Conclusion The technology of contrast enhancement scanning and Multiplanar reformation can distinguish carotid sheath area whiplash district whether being infringed partly or mass occupied.Therefore it is more accurately to divide the infringing range of the tumor than MSCT plain scanning，which can improve nasopharyngeal carcinoma clinical phased accuracy. 【Key words】 nasopharyngeal neoplasms carotid sheath area neoplastic invasion MSCT 鼻咽癌在我国属于常见病，在头颈部恶性肿瘤中发病率居首位［1］，鼻咽癌恶性程度高，易于发生直接蔓延和淋巴转移，据文献报道鼻咽癌多数直接蔓延侵犯颈动脉鞘区，而后发生同侧颈淋巴结转移［2］。根据我国的鼻咽癌92分期原则，颈动脉鞘区肿瘤部分侵犯和颈动脉鞘区肿物占据分别归为T2和T3期，因此正确区分颈动脉鞘区肿瘤是直接侵犯还是咽后淋巴结转移，直接影响到鼻咽癌的临床分期，也就影响肿瘤治疗计划的制定。本文通过比较102例鼻咽癌患者MSCT增强扫描及多平面重建与MSCT平扫资料，结合临床表现，分析比较MSCT增强及多平面重建与平扫对颈动脉鞘区受侵犯的敏感性，旨在提高对MSCT增强扫描及多平面重建在判断鼻咽癌颈动脉鞘区受侵犯价值的认识。 1 资料与方法 1.1 一般资料 选取2003年1月～2004年10月诊断的鼻咽癌病例共102例，所有病例符合下列条件：(1)病理证实为鼻咽癌；(2)检查前未