【摘要】 目的　探讨磁共振成像 (Magneticresonanceimage ,MRI)在口咽部恶性肿瘤诊断、疗效评价及术后复发监测中的应用价值。方法　收集资料完整的口咽部恶性肿瘤病例 30例 ,术前均行MRI检查 ,应用标准SE序列平扫及增强扫描 ,行轴位、矢状位及冠状位的T1WI、T2WI序列扫描 ,范围从颅底至颈根部。必要时部分病例行MRA检查。结果　肿块致口咽腔形态改变 ,但粘膜表浅的肿瘤MRI不易发现 ;软组织内肿块表现为T1WI像中等或中低信号、T2WI像中高或高信号 ;鳞癌一般边界不清信号不均匀 ,而恶性黑色素及恶性淋巴瘤边界较清楚、内部信号也比较均匀 ,颌骨中央性癌边界较清信号较均匀 ;肿块侵犯周围组织结构的状况在MRI像有较好显示 ,但对血管的显示有时需补充MRA检查 ;区域淋巴结转移状况的诊断假阴性较高 ,不能作为排除转移的主要手段 ;另外 ,MRI对放化疗效果判断及复发监测有一定价值 ;同时 ,Gd DTPA增强扫描在判断肿瘤性质 ,区别组织水肿及纤维化与肿瘤复发方面有一定帮助。结论　MRI对口咽部恶性肿瘤的定性、定位诊断、疗效评价及术后复发监测具有重要的参考价值更多还原

【Abstract】 ? Objective To investigate the MRI characteristic of oropharyngeal malignancies.Methods 30 patients with malignant tumor of the oropharynx were detected in transaxial,sagittle and cororal MRI scans before surgical treatment.The examination of all patients were carried out with plain spin echo sequence and Gd DTPA enhanced spin echo sequence,T1 weighted and T2 weighted image.Two patients were inspected with MRA to analyse the tumor invasion to the cervical atery.The data obtained from MRI were compared with the surgical and pathological findings.Results The size,shape,extent and site of oropharyngeal neoplasms and their involvement could be detected clearly by MRI,and the shape of oropharyngeal cavity altered with the growth of neoplasms.The superfacial lesion of mucosa could not be seen on the MRI,but the submucosal mass was easily found,and even the state of tumor infiltration into adjacent tissue was detected.On MRI,the nature of mass could be defined,and each type of neoplasms showed characteristics in shape,border,signal intensity and the pattern of invasion,but the histological diagnosis and the diagnosis of lympho nodes metastasis remained difficult.With the intensified signal of MRI,the effcts of radiotherapy and chemotherapy on tumor could be evaluated.Conclusions MRI provide useful information in the diagnosis of oropharyngeal neoplasms,in the evaluation of radiotherapy and chemotherapy,but it has defect in histological diagnosis and the diagnosis of superficial lesion and lympho nodes metastasis.更多还原