论文部分内容阅读
目的系统分析鼻咽纤维血管瘤累及解剖部位,探讨肿瘤术前不同影像学分期的准确性和临床应用价值。方法 94例鼻咽纤维血管瘤患者,以Radkowski(1996)分期标准为参照,按照鼻咽部邻近易累及的18个解剖部位分别编号,记录每例患者累及的解剖结构,对照临床手术分期结果,评价CT分期、MRI分期以及CT结合MRI分期3种模式的准确性。结果与手术分期对照(括号内为对应手术分期例数),70例CT检查分期结果:Ⅰa期4例(4例),Ⅰb期11例(3例);Ⅱa期5例(13例),Ⅱb期17例(19例),Ⅱc期21例(16例);Ⅲa期8例(9例),Ⅲb期4例(6例)。74例MRI检查分期结果是:Ⅰa期6例(6例),Ⅰb期2例(2例);Ⅱa期5例(5例),Ⅱb期21例(20例),Ⅱc期14例(18例);Ⅲa期17例(13例),Ⅲb期9例(10例)。50例CT联合MRI检查分期结果是:Ⅰa期2例(2例),Ⅰb期1例(1例);Ⅱa期4例(4例),Ⅱb期16例(17例),Ⅱc期11例(12例);Ⅲa期9例(7例),Ⅲb期7例(7例)。CT分期、MRI分期以及CT结合MRI分期3种模式中,经Kappa一致性检验,三者的Kappa值分别为0.81、0.92和0.95。结论以解剖结构为基础的CT结合MRI影像分期模式在鼻咽纤维血管瘤术前分期中准确性高,可作为术前分期依据。
Objective To systematically analyze the anatomic site of nasopharyngeal hemangiomas and discuss the accuracy and clinical value of different imaging stages before surgery. Methods Ninety-four patients with nasopharyngeal fibroadenoma were enrolled in the Radikowski (1996) staging system, and 18 anatomical sites that were easily involved in the nasopharynx were numbered respectively. The anatomic structures involved in each patient were recorded. The clinical stage, Evaluation of CT staging, MRI staging and CT combined MRI staging accuracy of the three modes. The results were compared with the surgical stage (the corresponding number of surgical staging in the brackets). The staging results of 70 cases of CT examination were as follows: stage Ia in 4 cases (4 cases), stage Ib in 11 cases (3 cases), stage IIa in 5 cases (13 cases) There were 17 cases of stage IIb (19 cases), 21 cases of stage IIc (16 cases), 8 cases of stage IIIa (9 cases) and 4 cases of stage IIIb (6 cases). 74 cases of MRI examination staging results are: Ⅰ a period in 6 cases (6 cases), Ⅰ b period in 2 cases (2 cases); Ⅱ a period in 5 cases (5 cases), Ⅱ b period in 21 cases (20 cases), Ⅱc period in 14 cases Cases), stage Ⅲa 17 cases (13 cases), stage Ⅲ b 9 cases (10 cases). 50 cases of CT combined with MRI staging results are: Ⅰ a period of 2 cases (2 cases), Ⅰ b period in 1 case (1 case); Ⅱ a period in 4 cases (4 cases), Ⅱ b period in 16 cases (17 cases), Ⅱ c period in 11 cases (12 cases), stage Ⅲa in 9 cases (7 cases) and stage Ⅲb in 7 cases (7 cases). Among the three models of CT staging, MRI staging and CT staging, the Kappa values of the three methods were 0.81, 0.92 and 0.95 respectively. Conclusion The CT-combined MRI imaging staging model based on anatomical structure has high accuracy in the preoperative staging of nasopharyngeal fibrovascular tumors and can be used as a preoperative staging basis.