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目的 加深对鼻咽癌 (NPC)侵犯翼腭窝 (PPF)CT表现的认识 ,以提高临床对NPC侵犯范围诊断的准确性。方法 回顾分析 66例颅底受侵的NPC病例 ,并对 3 0例颅底受侵的NPC病例作了前瞻性研究。回顾性病例均为常规扫描 ,前瞻性病例则加作高分辨率CT(HRCT)扫描。结果96例中 ,共有 41例PPF受累 ,经蝶腭孔累及者 2 1例 ,经颞下窝累及者 5例 ,不能确定途径者 1 5例。PPF受侵后可经蝶筛隐窝或翼管侵犯蝶窦 ,本组共有 7例。经HRCT发现翼管和蝶窦受累的病例中 ,冠状面显示分别为 1 1例和 1 0例 ,而横断面显示分别为 5例和 3例 ,二者间差异具有显著性意义(P <0 0 5)。结论 PPF是NPC易于累及的部位 ,肿瘤经此常累及相邻结构 ,其中对蝶窦的侵犯方式值得注意。横断面HRCT较常规横断面CT更能清楚显示翼管、蝶窦等结构的骨质破坏 ;而冠状面HRCT显示翼管及蝶窦受累的情况则显著优于横断面HRCT。
Objective To deepen the cognition of CT manifestations of nasopharyngeal carcinoma (NPC) infiltrating the pterygopalatine fossa (PPF) in order to improve the accuracy of clinical diagnosis of NPC. Methods A retrospective analysis of 66 cases of skull base invasion of NPC cases, and 30 cases of skull base invasion of NPC cases were prospectively studied. Retrospective cases were routine scans and prospective cases were treated with high-resolution CT (HRCT) scans. Results A total of 41 cases of PPF were involved in the study. Twenty-one patients were involved in transection of the sphenopalatine fossa, 5 patients were involved in the infratemporal fossa, and 15 were not identified. After the invasion of PPF by butterfly stenosis or wing tube sphenoid sinus invasion, a total of 7 cases in this group. Coronary findings were 11 and 10 cases, respectively, in the cases of PVT and sphenoid sinus involvement, while the cross-sectional images were 5 and 3, respectively, with significant differences between the two groups (P <0 0 5). Conclusions PPF is the site of NPC easy to be involved. The tumor usually involves the adjacent structure, and the way of invasion of the sphenoid sinus is worth noting. The cross-sectional HRCT clearly shows the destruction of the vasculature such as the sphenoid duct and the sphenoid sinus, compared with the conventional cross-sectional CT. The coronal HRCT shows that the involvement of the sphenoid and sphenoid sinus is significantly better than the cross-sectional HRCT.