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目的：分析ＣＴ在鼻咽癌诊断及肿瘤定位中的作用，探讨咽旁间隙侵犯对预后的影响。材料与方法：本组经活检病理证实鼻咽癌１３０例，治疗前均行鼻咽ＣＴ检查，层厚、层距各５ｍｍ。平扫５１例，平扫加增强２例，增强扫描７７例。结果：ＣＴ能显示早期鼻咽癌患侧咽陷窝变钝、闭塞，腭帆提肌增厚及其他粘膜下浸润，能较清楚地显示肿瘤生长部位、病变范围及浸润深度。采用Ｓｈａｍ等提出的测量方法，８５．４％病例有不同程度的咽旁间隙侵犯，咽旁间隙侵犯程度与肿瘤局部控制有关（Ｐ＜０．０１）；１０２例随访时间大于２３月的Ｔ１～Ｔ３病例中原无咽旁间隙侵犯病例１／１８复发，原有不同程度咽旁间隙侵犯病例２０／８４复发，两者统计学上无显著差异（Ｐ＞０．０５）。本组未见仅有咽旁间隙复发而无鼻咽腔累及病例。肿瘤向颈动脉鞘区侵犯程度与颈部淋巴结转移有关（Ｐ＜０．０１）。结论：（１）ＣＴ在鼻咽癌诊断及肿瘤定位中有重要价值；（２）咽旁间隙侵犯不是影响肿瘤复发的主要因素；（３）颈动脉鞘区受侵与颈部淋巴结转移有密切关系。
Objective: To analyze the role of CT in the diagnosis and localization of nasopharyngeal carcinoma (NPC) and explore the influence of parapharyngeal space clearance on prognosis. Materials and Methods: The group of 130 cases of nasopharyngeal carcinoma confirmed by biopsy pathology, nasopharyngeal CT examination before treatment, layer thickness, layer spacing of 5mm. 51 cases of plain scan, scan and enhancement in 2 cases, enhanced scan in 77 cases. Results: CT showed that the ipsilateral pharyngeal fossa of the nasopharyngeal carcinoma became obtuse, occluded, levator thickened levator mucosa and other submucosal infiltrates in early stage of nasopharyngeal carcinoma, which could clearly show the tumor growth sites, the extent of lesions and the depth of invasion. According to the measurement method proposed by Sham et al, 85.4% cases had different degrees of parapharyngeal space invasion, the parapharyngeal space invasion degree was related to tumor local control (P <0.01); 102 cases were followed up for T1 ~ There was no recurrence of paraquat clearance in 1/13 of T3 cases, and 20/84 recurrence of parapharyngeal clearance was found in the original cases. There was no significant difference between them (P> 0.05). No recurrence of parapharyngeal space in this group and no cases of nasopharyngeal involvement. The extent of tumor invasion into the carotid sheath was related to cervical lymph node metastasis (P <0.01). Conclusion: (1) CT is of great value in the diagnosis and localization of NPC; (2) invasion of parapharyngeal space is not the main factor affecting tumor recurrence; (3) invasion of carotid sheath is closely related to cervical lymph node metastasis relationship.