鼻咽癌颅底侵犯冠状位CT扫描应用价值分析

目的探讨冠状位CT扫描在鼻咽癌颅底侵犯诊断中的应用价值。方法对233例鼻咽癌患者进行轴位及冠状位CT扫描,比较两种体位对鼻咽癌颅底侵犯的检出情况。结果轴位扫描所见肿瘤侵袭、转移灶中173例经冠状位扫描证实;轴位扫描无骨质侵袭及转移者16例中,经冠状位扫描见4例骨质破坏;轴位扫描所见10例难以确定是否骨质破坏者,经冠状位扫描证实4例骨质破坏,6例正常;另外,冠状位扫描显示了21例轴位扫描未发现的骨质破坏;同时有21例患者轴位扫描可见骨质破坏,但冠状位仅显示12例,且位置不同。结论 CT扫描在鼻咽癌颅底侵犯影像诊断中具有重要意义,但单纯轴位扫描具有一定局限性,联合应用轴位与冠状位的扫描,可提高诊断准确率。

Analysis on value of CT coronal scan in diagnosis of invasion of skull base in nasopharyngeal carcinoma

OBJECTIVE To discuss the clinical value of CT coronal scan in diagnosis of invasion of skull base in nasopharyngeal carcinoma(NPC).METHODS 233 patients with NPC were given CT coronal and axial scan,then compared the results of the two positions.RESULTS In the 233 cases of NPC,CT coronal scan showed bone invasion in 4 cases in 16 cases that had not been recognized by axial scan.By CT coronal scan,the invasion of skull base was confirmed in 4 and excluded in 6 of 10 cases in which the invasion was uncertain by axial scan.Wider and deeper invasions were recognized in 23 cases(12.3%)by coronal scan,though obvious invasion had been diagnosed after axial scan.Accordant invasion was displayed in 35 cases(18.8%)by CT coronal and axial scan.By CT coronal scan,the invasion of skull base was in 21 patients witch had not been showed destruction of bone.And there was destruction of bone in 21 cases by axial scan,only 12 cases could be recognized in coronal scan,and with different locations.CONCLUSION CT scan is valuable for invasion of skull base in NPC,combining CT axial with coronal scan can improve diagnostic accuracy.