鼻咽癌咽周间隙浸润与淋巴结转移及与远处转移的关系影像学研究（附59例分析）

目的：通过影像分析探讨鼻咽癌咽周间隙的浸润与颈部淋巴结转移及与远处转移的关系,为临床制定适合的治疗方案提供有价值的影像信息。方法：回顾性研究59例经病理证实的鼻咽癌CT及MR表现,将影像检查结果按咽周间隙有无浸润分为浸润组和无浸润组,通过卡方检验法对两组病人有无颈部淋巴结转移及远处转移进行分析对照。结果：茎突后间隙受侵及咽后间隙受侵与颈部淋巴结转移有明显相关性（P〈0.01）,茎突前间隙受侵与颈部淋巴结转移无相关性（P〉0.05）;鼻咽癌原发灶中,侧壁受侵时颈部淋巴结转移比例最高,为83.3%,其次是顶后壁,为71.9%;鼻咽癌周围组织侵犯病例中,口咽、喉咽、后组颅神经受侵时颈部淋巴结转移阳性比例与阴性比例差别显著。远处转移与颈部淋巴结转移有相关性（P〈0.05）。结论：鼻咽癌咽周间隙浸润与颈部淋巴结转移及远处转移有密切关系。

Imaging study of the relationship of parapharyngeal space infiltration in nasopharyngeal cancer with lymph node and distant metastasis(analysis of 59 cases)

Objective： To evaluate the relationship between the parapharyngeal space involvement of nasopharyngeal carcinoma（NPC） and cervical lymph node metastasis along with the distant metastasis by the analysis of the imaging. We can offer more imaging informations for clinic to diagnose NPC earlier. Materials and Methods CT or MR features of NPC in 59 cases which were proved by pathology were analyzed retrospectively and were divided into two groups depending on whether the parapharyngeal space was involved or not. We analysed and compared the two groups whether cervical lymph node metastasis and distant metastasis were happened or not by chi-square test. Results： Involvements of the poststyloid space and retropharyngeal space had significant relation with the cervical lymph node metastasis （P〈0.01）, involvement of the prestyloid space was irrelevant to the cervical lymph node metastasis （P〉0.05）. Among the primary focus of NPC, when the lateral wall was infiltrated by the tumor, the rate of cervical lymph node metastasis was the highest （83.3%）; when the top and posterior wall was extended. The rate of cervical lymph node metastasis was of the second highest （71.9%）. Among the cases of NPC, when the oropharynx, hypopharynx and the 9, 10, 11, 12th cranial nerves were involved, the distinction of the proportions of whether cervical lymph node metastasized or not was relevant. The distant metastasis was relevant to the cervical lymph node metastasis（P〈0.05）. Conclusion： The parapharyngeal space involvement of nasopharyngeal carcinoma was pertinent to the cervical lymph node metastasis and distant metastasis.