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目的通过64排螺旋CT扫描及多平面重建对早期鼻咽癌及周围骨质破坏的诊断价值进行分析。方法对经64排螺旋CT扫描及多平面重建的42例鼻咽癌患者的临床资料进行回顾性分析。结果 42例鼻咽癌患者影像结果显示:(1)鼻咽侧壁改变33例,鼻咽一侧或双侧壁增厚26例;(2)鼻咽腔结构变形,咽鼓管圆枕肿大,一侧或双侧咽隐窝消失17例,鼻咽壁增厚及组织肿块导致咽隐窝消失、变平及移位,突入鼻咽腔致其不对称狭窄或闭塞;(3)咽旁间隙受累13例,表现咽旁间隙显示欠清,咽旁间隙的脂肪结构消失及不规则软组织肿块,引起咽旁间隙变形、移位甚至消失;(4)颅底骨质破坏12例,CT显示颅底骨质呈“虫蚀”样改变。正常骨形态消失,部分骨质边缘不规则缺损,缺损骨质为软组织替代;(5)颈部淋巴结转移23例,CT显示颈部单侧或多个软组织样密度影,有强化,部份融合成团块状改变,增强扫描有强化。淋巴结肿大者可发生液化坏死,以上颈部多见。结论 64排螺旋CT对鼻咽癌早期诊断及周围骨质破坏诊断研究及早期临床治疗具有重要价值。
Objective To analyze the diagnostic value of early stage nasopharyngeal carcinoma and surrounding bone destruction by 64-slice spiral CT scan and multiplanar reconstruction. Methods The clinical data of 42 patients with nasopharyngeal carcinoma treated by 64-slice spiral CT and multiplanar reconstruction were analyzed retrospectively. Results The imaging results of 42 patients with nasopharyngeal carcinoma showed that: (1) the nasopharyngeal wall was changed in 33 cases, the nasopharyngeal side or the bilateral wall was thicken in 26 cases; (2) the nasopharyngeal cavity structure was deformed, Large, one or both sides of the disappearance of 17 cases of pharyngeal crypts, nasopharyngeal wall thickening and tissue mass led to the disappearance of pharyngeal crypts, flattening and displacement into the nasopharynx resulting in asymmetric stenosis or occlusion; (3) pharyngeal Side of the gap involvement in 13 cases, the performance of the parapharyngeal space showed that the lack of clear, the parapharyngeal gap disappeared fat tissue and irregular soft tissue mass, causing parapharyngeal space deformation, displacement or even disappear; (4) 12 cases of skull base bone destruction, CT Show skull bone was “worm eaten” like change. Normal bone morphology disappeared, part of the irregular edge of the bone defect, defect of soft tissue replacement for bone replacement; (5) cervical lymph node metastasis in 23 cases, CT showed one or more neck soft tissue density, enhanced, partial fusion Into the clumpy change, enhanced scanning has enhanced. Lymphadenopathy may occur liquefaction necrosis, more common in the neck. Conclusion 64-slice spiral CT has important value in the early diagnosis of nasopharyngeal carcinoma and in the diagnosis and early clinical treatment of the surrounding bone destruction.