【摘要】 目的探讨鼻咽癌放疗后继发咽旁感染的临床诊断与影像学特点。方法1997年1月至2008年8月共收治鼻咽癌放疗后咽旁感染40例患者,多以颞侧头痛(62.5%)和咽部疼痛(22.5%)为首发症状。鼻咽纤维镜检查其中35例鼻咽黏膜呈不同程度感染、溃疡或坏死样改变(87.5%),5例见结节状肿物。CT与MRI误诊为鼻咽部复发或疑诊复发共14例(35.0%)。全部病例给予抗炎治疗。结果所有病例经抗炎治疗后疼痛症状消失。影像学复查1例鼻咽及咽旁肿物完全消退,30例黏膜感染、溃疡及咽旁软组织增厚范围稍有缩小或变化不大。随访10～150个月,36例无瘤存活至今,4例死于肺炎呼吸衰竭。结论鼻咽癌放疗后咽旁感染,其临床和影像学均易与鼻咽肿瘤复发相混淆。其特点为慢性发病、曾有高剂量放疗史、颞侧或咽部疼痛、鼻咽黏膜感染、溃疡或坏死等。CT与MRI见咽旁可疑肿块影。抗炎治疗效果好。更多还原

【Abstract】 Objective To investigate the clinical diagnosis and imaging feature of parapharyngeal infection in patients with nasopharyngeal carcinoma after radiotherapy.Methods Forty patients with parapharyngeal infection after radiotherapy of nasopharyngeal carcinoma were treated from January 1997 to August 2008.The major symptoms were temporal headache(62.5%) and pharyngeal soreness(22.5%).Under the examination of nasopharyngeal fiberscope,different extent of infection,ulcer or necrosis lesion was found in 35 cases(87.5%),while nodular neoplasm in the nasopharyngeal cavity was found in the other 5 cases.Fourteen patients(35.0%) were misdiagnosed or suspected to have relapse of nasopharyngeal carcinoma by CT or MRI scan.All patients received anti-inflammatory therapy.Results The symptom of pain disappeared in all patients after anti-inflammatory therapy.The neoplasm in nasopharynx and parapharyngeal space completely regressed in one case on imaging reexamination.The extent of infection,ulcer and parapharyngeal soft tissue thickening were slightly reduced or without any change in 30 cases.After 10-150 months follow-up,36 patients were still alive without tumor relapse,4 patients died of pneumonia and respiratory failure.Conclusion Parapharyngeal infection after radiotherapy of nasopharyngeal carcinoma was easily misdiagnosed as relapes of nasopharyngeal carcinoma by clinical feature and imaging examination.The characteristics of these cases were as follows: chronic disease,after high dose radiotherapy,temporal headache or pharyngeal soreness,nasopharyngeal infection,ulcer or necrosis,doubtful parapharyngeal neoplasm on CT or MRI scan,effective by anti-inflammatory therapy.更多还原