254例鼻咽癌颈淋巴结转移的MRI诊断

目的进行大样本鼻咽癌颈淋巴结转移的MRI研究,旨在探索鼻咽癌颈淋巴结转移的规律及MRI信号特点。方法收集经病理组织学确诊的初治鼻咽癌315例,全部病例进行鼻咽部MRI检查,行自旋回波轴位、冠状、矢状位T1WI、轴位T2WI扫描及常规增强MRI扫描。结果315例患者中,254例(80.6%)有淋巴结转移,咽后淋巴结最常受累。鼻咽病灶位于双侧者,其颈淋巴结转移率明显较单侧者高。与鼻咽病灶均匀信号不同,颈部转移淋巴结的中央坏死、包膜外侵犯及融合发生率较高。结论鼻咽癌颈淋巴结转移发生率高,以咽后淋巴结最多见。鼻咽病灶位于双侧者淋巴结转移率明显较单侧者高。鼻咽癌颈部转移淋巴结的坏死、包膜外侵犯及融合发生率较高。

MRI study of metastatic cervical nodes in 254 cases of nasopharyngeal carcinoma

Objective To explore the distribution and features of cervical nodes metastasis from nasopharyngeal carcinoma(NPC).Methods The MR imagings of 315 patients with newly diagnosed NPC were reviewed retrospectively.Nasopharyngeal MRI scan was performed in all patients.Conventional plain MRI sequences including axial,coronal and sagittal T1 weighted-imaging and axial T2 weighted-imaging were done.Conventional T1 contrast enhanced imaging was obtained after bolus injection of Gd-DTPA.Results Of 315 patients,254(80.6%) had cervical lymphadenopathy.Of the 254 neck positive cases,233 cases showed enlargement of retropharyngeal nodes(RN),which were most commonly involved.A higher incidence in metastatic cervical nodes was seen in patients with primary tumor located on bilateral than on unilateral nasopharynx(x2 = 5.125,P < 0.05).Central necrosis and extracapsular spread and fusion were easier to be seen in metastatic cervical nodes than in nasopharynx.Conclusion NPC has a high incidence of cervical lymph node metastases.Nodes in RN are most commonly involved.There are more metastatic cervical nodes in patients with primary tumor located on bilateral than on unilateral nasopharynx.The incidence of central nodal necrosis and extracapsular nodal spread and fusion was very high.