鼻咽癌侵犯颈动脉间隙MRI诊断

目的：着重探讨鼻咽癌侵犯动脉间隙的RI表现特征。方法：回顾性分析经临床和病理证实的鼻咽癌侵犯颈动脉间隙MRI资料28例。采用Elscient GyrexV型MR机。自旋回波序列,横断位,T1WI（440／25ms）,PDWI（2200／20ms）和T2WI（2200／90ms）计28例,冠状位,T1WI（440／25ms）计8例,磁显葡胺MR增扫4例。结果：（1）颈动脉间隙不对称,右侧17例,左侧8例,双侧3例。（2）颈内动脉和颈内静脉受压移位16例,包裹缩窄8例,不清4例,（3）沿颈动脉间隙侵犯海绵窦8例,侵犯口咽部9例;（4）咽后淋巴结肿大,单侧8例,双侧4例;（5）颅底骨质破坏中,颈静脉孔受累6例,蝶骨受累5例,斜坡受累3例;（6）病变信号表现中,T1加权呈等信号15例,低7例,不均信号6例;T2加权呈高信号23例,不均信号5例;（7）MR增扫呈斑片状强化4例;（8）腮腺向前推移7例,头长肌不清8例。结论：鼻咽癌侵犯颈动脉间隙的部位、范围和类型等MRI表现特征,对临床放射治疗方案的实施,可提供重要影像信息。

Diagnosis of Carotid Space Invaded by Nasopharyngeal Carcinoma on MRI

Objective:To study MRI features of carotid space invaded by nasopharyngeal carcinoma(NPC).Materials and Methods:Twenty-eight cases of MRI in NPC diagnosed clinically and pathologically were reviewed respectively.With Elscient Gyrex V MR System,0 5T,Superconduct.SE,axial view,T 1WI(440/25ms),PDWI (2200/20ms)and T 2WI(2200/90ms)in 28cases,and coronal view,T 1WI(440/25ms) in 8 cases,and Gd DTPA enhancement in 4 cases.Results:(1)asymmetry of Carotid space,right side in 17cases,left side in 8 cases and bilateral in 3 cases;(2)compressed or displacement of internal caroted artery and internal jugular vein in 16 cases,encasement or narrowing of ICA and IJV in 8 cases,and identifiable in 4 cases;(3)Spread of carcinoma along the carotid sheath to cavernous sinus in 8 cases,and/or to oropharynx in 9 cases;(4)enlargement of retrophargngeal node;unilateral in 8 cases and bilateral in 4 cases;(5)destruction of base of skull,jugular foramen in 6 cases,sphenoid bone in 5 cases and divus in 3 cases;(6)characteristic of signal intensity;isointensity in 15 cases,low signal intensity in 7 cases,inhomogeneous signal intensity in 6 cases on T 1WI,and high signal intensity in 23 cases,and inhomogereous signal intensity in 5 cases on T 2WI;(7)spot enhancement in 4 cases;(8)displacement of parotid gland in 7 cases,longus capitis indistinguishable in 8 cases.Conclusion:important informations to clinician in planning the radiotherapy regime.Characteristic features of location,extent,types of the carotid space invaded by NPC on MRI provide.