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目的探讨鼻咽癌侵犯海绵窦的发生率、主要侵犯途径及MRI特点。方法经病理证实并经MRI检查的鼻咽癌患者141例,使用1．5 T超导MR机进行检查,增强扫描前行快速自旋回波(FSE)序列横断面T1WI、T2WI扫描,增强后采用快速扰相梯度回波(FSPGR)脂肪抑制序列横断面及冠状面扫描。由两位经验丰富的放射科医师读片。结果141例患者中,有39例(49侧)海绵窦受侵犯,发生率为27．7％。卵圆孔为最常见的单一侵犯途径,有18侧仅通过卵圆孔侵犯海绵窦,占36．7％;多途径侵犯海绵窦的患者中,有6侧(12．2％)经卵圆孔与破裂孔侵犯海绵窦,为最常见共同途径。最常见的MRI表现为海绵窦增大伴异常强化(22侧),其次为海绵窦壁局限性或弥漫性增厚和(或)海绵窦内血管、神经结构紊乱或模糊不清(18侧),海绵窦局部形成肿块者9侧。结论卵圆孔是鼻咽癌侵犯海绵窦的主要途径。MRI能有效、准确地判断鼻咽癌侵犯海绵窦的情况,对指导临床采取正确治疗措施具有重要价值。
Objective To investigate the incidence of nasal cavernous sinus invasion of nasopharyngeal carcinoma, the main ways of invasion and MRI features. Methods A total of 141 nasopharyngeal carcinoma patients confirmed by pathology and examined by MRI were examined with 1.5 T superconducting MR machine and enhanced with T1WI and T2WI scan of fast spin echo (FSE) sequence scan before enhancement Fast Scrambling Gradient Echo (FSPGR) fat suppression sequence cross-sectional and coronal scan. Read by two experienced radiologists. Results Of 141 patients, 39 cases (49 sides) of the cavernous sinus were infringed, the incidence was 27.7%. Foramen ovale was the most common single invasion, 18 cavernous sinus was infiltrated only through the foramen ovale, accounting for 36.7%. Among the patients with multiple cavernous sinus invasion, 6 (12.2% Holes and ruptured holes invade the cavernous sinus, the most common common pathway. The most common manifestations of MRI were enlarged aneurysm with abnormal enhancement (22 sides), followed by focal or diffuse thickening of the cavernous sinus wall and / or vessels in the cavernous sinus, disorganized or unclear nerves (18 sides) Local cavernous sinus formed mass 9 side. Conclusions Foramen ovale is the main way of nasopharyngeal carcinoma invading the cavernous sinus. MRI can effectively and accurately judge the situation of nasopharyngeal carcinoma invading the cavernous sinus, which is of great value in guiding the clinical treatment.