CT扫描在鼻咽癌临床分期中的作用：附60例报告

通过６０例鼻咽癌患者放疗前鼻咽ＣＴ扫描图象，分析ＣＴ扫描对鼻咽癌临床分期的作用。ＣＴ扫描可发现粘膜下软组织的病变，并能显示病变向鼻咽腔外邻近组织侵犯的范围及颅底骨质破坏程度。结合ＣＴ扫描使常规临床分期发生了较大的变化，Ｔ０从１．６％下降为０％；Ｔ１、Ｔ２分别从１６．６％、３０％下降为５％、１０％；而Ｔ３，Ｔ４分别由３１．６％、２０％上升为３５％、５０％。６０例中常规临床分期与结合ＣＴ扫描分期相符者２２例（３６．７％），Ｔ分期升级者３８例（６３．３％），其中以Ｔ２上升为Ｔ３、Ｔ４者最多——４２％（１６／３８），Ｔ３上升为Ｔ４者次之——３６．８％（１４／３８）。升级原因主要是肿瘤超腔侵犯了咽旁间隙、颈动脉鞘区和颅底骨质破坏等。结合ＣＴ扫描能较准确地提供临床分期的依据，使放疗方案设计更合理，有利于提高疗效，延长生存期。

Inflence of CT Scaning on Clinical Staging of Naso pharingeal cancer

From Jan 1990 to Dec 1991,before therapg,60 nasopharyngealcarcinoma patients were scanned withGE9000 CT scanner in the AffiliatedHosp.of Ningxia Med.Coll.All pa-tients were proved by histopathologi-cal examination and clinlcal examina-tion and X-ray plate.CT scan as compared with routineclinical examination was found to bemore sensitive in:1) Being ableof early diagnosls by showing earlysubmucosal soft tissue involvement; 2)showing involvement of Iateral andposterior wall of the nasopharynx;(3)revealing the extranasopharyn-geal extension,parapharyngeal andnasal cavlties,paranasal sinuses,carotic sheath area,and bone destruc-cations;(4)being more accurate indetection of primary lesion,extrana-sopharyngeal extension and especiallyT staging.In this series,comparing to con-ventional clinical staging,38 cases(63.3%)were raised up in CT scan-ning.In primary Iesion (T)staing,To decreased from1.6%to 0%;and t2 decreated from 16.6%to 5%and from 30%to 10% respectivery;noteworthily,T3 and T4 increasedfrom 31.6%to 35%and from 20%to50% respectively,becamse more ext-ranasopharyngeal extensions and bonedestruetions were displayed by CTScan.