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目的:探讨鼻咽癌放疗后CT、影像变化规律。材料与方法:放疗后无瘤生存3年以上,并有较完整各时段CT复查资料的鼻咽癌患者56例,按92’鼻咽癌分期T_113例、T_219例、T_317例、T_49例。总结分析患者放疗前、放疗结束时、放疗后2～9月、放疗后1～2年、放疗后2年以上鼻咽CT影像变化特点。结果:放疗结束时,73.2％(41/56)鼻咽结构基本恢复正常,26.8％(15/56)患侧鼻咽局部仍增厚;放疗后2～9月,89.3％(50/56)咽壁肿胀增厚,咽腔变形、变窄;放疗后1～2年咽壁肿胀增厚逐渐减轻、僵直;放疗后2年以上85.7％(48/56)咽壁变薄、僵直,咽腔扩大。咽旁间隙狭窄放疗结束时61.1％(22/36)恢复正常;放疗结束时未恢复正常者,放疗后恢复呈渐进过程,放疗后3年仍有8.3％(3/36)未恢复正常。颅底骨质破坏难以完全修复,部分患者可部分修复。副鼻窦侵犯者88.9％(8/9)放疗结束时肿瘤完全消退。全组放疗后100％在不同时期出现过不同程度的副鼻窦炎,放疗2年以后明显减少、减轻。结论:鼻咽癌放疗后CT影像表现随时间变化有一定规律。探讨和掌握这些规律,对减少鼻咽癌放疗后CT误诊复发具有重要参考价值。
Objective: To investigate the changes of CT and images after radiotherapy for nasopharyngeal carcinoma. Materials and Methods: 56 patients with nasopharyngeal carcinoma who had no tumor survival for more than 3 years after radiotherapy, and more complete CT scan data for each stage. According to 92′ nasopharyngeal carcinoma stage, T_113 cases, T_219 cases, T_317 cases, and T_49 cases. Summarize the characteristics of CT images before and after radiotherapy, at the end of radiotherapy, from 2 to 9 months after radiotherapy, 1 to 2 years after radiotherapy, and more than 2 years after radiotherapy. Results: At the end of radiotherapy, 73.2% (41/56) of the nasopharyngeal structures returned to normal, and 26.8% (15/56) of the affected side of the nasopharyngeal area remained thick; 89.3% (50/56) from 2 to 9 months after radiotherapy. Pharyngeal wall swelling and thickening, pharyngeal cavity deformation, narrowing; pharyngeal wall swelling and thickening gradually reduced and stiffened in 1 to 2 years after radiotherapy; 85.7% (48/56) of pharyngeal wall thinning, stiffness, and pharyngeal cavity more than 2 years after radiotherapy expand. 61.1% (22/36) of the stenosis of the parapharyngeal space had returned to normal at the end of radiotherapy. At the end of radiotherapy, it had not returned to normal. After radiotherapy, the recovery progressed gradually. However, 8.3% (3/36) of the patients did not return to normal after 3 years of radiotherapy. Skull bone destruction is difficult to completely repair, some patients can be partially repaired. 88.9% (8/9) of paranasal sinus aggressors completely resolved tumors at the end of radiotherapy. 100% of all groups had different degrees of paranasal sinusitis at different times after radiotherapy, and radiotherapy significantly reduced or reduced after 2 years. Conclusion: The CT imaging manifestation changes with time after nasopharyngeal carcinoma has certain rules. To explore and master these laws has important reference value for reducing misdiagnosis and recurrence of CT in nasopharyngeal carcinoma after radiotherapy.