【摘要】 目的观察MRI与CT在揭示鼻咽癌(NPC)颅底骨破坏及咽旁间隙受累中的鉴别诊断和在适形放疗模拟中的应用价值。方法经病理证实90例鼻咽癌病人同时作MRI和CT,对比显示鼻咽周围结构受累和颅底骨破坏情况。结果通过MRI见颅底骨受累率、椎前肌受累率和咽后淋巴结转移率分别为71.1%、33.0%和60.0%,而CT的相应值仅35.0%、7.8%和13.3%,各对应值之间有明显的统计学差异(χ2=22.86;17.99;42.20,P<0.001)。MRI能根据T2WI上的不同信号强度判别是鼻咽癌侵及副鼻窦还是炎症,而CT不能作到这一点,MRI能根据各种结构的具体位置及固有的不同信号确定茎突后间隙和颈动脉鞘附近的淋巴结转移。结论MRI在鼻咽癌颅底骨及咽旁间隙受累和炎症鉴别方面优于CT,是首选影像学检查法。在鼻咽癌适形放疗中,MRI模拟较CT模拟更具有优越性。更多还原

【Abstract】 Objective To compare the applied value of MRI and CT in simulated location of conformal radiotherapy for NPC.Methods MRI and CT with imaging sections in 90 cases of NPC pathologically proved were compared as to the frequency of involving pharyngeal neighbor and bony structures of cranial base.Results The frequencies of involving the bone of cranial base,prevertebral muscles and retropharyngeal nodes,by MRI and CT,were:71.1% vs 35.6%,33.3% vs 7.8% and 60% vs 13.3%,respectively.The differences therein were statistically significant（χ²=22.86;17.99;42.20,P<0.001）.By MRI,invasion of the paranasal sinnus was demonstrated by the different singal intensities-T₂WI which was not available by CT.By MRI,the poststyloid space and carotid sheath involvement of node matastases were detected by different structure and concrete site of signal intensity.Conclusion MRI surpasses CT in demonstrating involvement of bony erosion of cranial base and the space of pharyngeal neighbor or inflammation.MRI is first choice of imaging examination in NPC.Thus,MRI is superior to CT in simulated location for NPC in conformal radiotherapy.更多还原