【摘要】 目的:探讨SPECT和CT对鼻咽癌颅底骨侵犯的检测能力及临床价值。方法:对50例初治鼻咽癌患者放疗前同期进行前瞻性SPECT和CT检测,比较两者的检出率及与临床症状、体征、T、N分期的相关性。结果:SPECT和CT对鼻咽癌颅底骨侵犯的阳性检出率在全部患者中分别为60%和36%;在头痛、颅神经损害及两者并存患者中分别为83.3%、25%;100%、0;94.4%、77.8%。在T1+T2及T3+T4的患者中分别为18.2%、0;92.9%、64.3%。在N0+N1及N2+N3的患者中分别为67.7%、45.5%;41.2%、17.6%。在Ⅰ+Ⅱ及Ⅲ+Ⅳ期的患者中分别为20%、0;70%、45%。SPECT的阳性检出率明显高于CT,差异有统计学意义,P<0.05。Binarry Logistic回归分析显示,头痛及T分期是SPECT阳性检出的危险因素(OR头痛=11.92,ORT分期=15.43);颅神经损伤是CT阳性检出的危险因素(OR颅神经损伤=7.50)。结论:结合患者头痛、颅神经损害症状、T、N分期,综合SPECT和CT检测结果,提高鼻咽癌患者早期颅底骨受侵犯的检出率和诊断的准确性是可行且有实际意义的。更多还原

【Abstract】 OBJECTIVE:To investigate the abilities of SPECT and CT scan to detect skull base invasion in nasopharyngeal carcinoma.METHODS:Fifty patients with nasopharyngeal carcinoma were scaned by SPECT and CT to compare the skull base invasion detection rates and their correlation to clinical symptoms,signs,and T-N stages.RESUTLS:The overall detection rates of skull base invasion by SPECT and CT were 60% and 36% respectively.The patients with headache,cranial nerve palsy and both,were detected at 83.3% and 25%;100% and 0;94.4% and 77.8% respectively.The patients with T1+T2 and T3+T4 stages,were detected at 18.2% and 0,and 92.9% and 64.3% respectively.The patients with N0+N1 and N2+N3 stage,were detected at 67.7% and 45.5%;41.2% and 17.6% respectively.Finally,the patients with Ⅰ+Ⅱ and Ⅲ+Ⅳ stage,were detected at 20% and 0;70% and 45 % respectively.The detection rates by SPECT scanning were significantly higher than by CT scanning(P<0.05).Binary logistic regression analysis showed that headache and T stages were risk factors of detection of skull base invasion by SPECT(ORheadache=11.92,ORT stage=15.43),while cranial nerve palsy was the risk factor of detection by CT(ORcranial nerve palsy=7.50).CONCLUSION:Combining headache and cranial nerve palsy with T and N stage,we may improve the detection of skull base invasion in nasopharyngeal carcinoma by SPECT and CT.更多还原