CT、MRI对鼻咽癌颅底骨质侵犯的检测及诊断价值

目的研究螺旋CT与MRI诊断鼻咽癌颅底骨质侵犯的价值。方法收集本院2010年1—12月经病理证实的29例鼻咽癌颅底骨质侵犯患者的临床资料．并对这些患者的CT和MRI检查结果进行分析。结果CT的表现为虫蚀样，皮质骨模糊增厚，或有皮质骨因硬化而增生，在同一病例中，可在不同部位出现骨质破坏，MRI的影像表现为高信号的骨髓信号消失，取代为肿瘤的中等信号。且增强扫描后有明显强化。29例患者中，CT检出10例，检出率为34．5％，其中，单部位3例，占10-3％；多部位7例，占24．1％。MRI检出21例，检出率为72．4％，其中，单部位8例，占27．6％；多部位13例，占44．8％，两种检测结果比较，差异有统计学意义（P〈0．05）。CT检出颅底各部位骨质侵犯最多的是岩锥尖，其次是翼板：MRI检出颅底各部位骨质侵犯最多的是岩锥尖，其次是斜坡骨。结论MRI诊断能够提高鼻咽癌颅底骨质侵犯的确诊率，有利于早日确诊并及时得以治疗，在鼻咽癌颅底骨质侵犯的定位和治疗方案的选择上有一定的价值。

Detection and diagnosis value of CT and MRI on skull base bone invasion of nasopharynx cancer

Objective To study the detection and diagnosis value of CT and MRI on skull base bone invasion of na- sopharynx cancer （NPC）. Methods Clinic data of 29 patients who had been diagnosed as NPC by pathology from Jan- uary 2010 to December 2010 were analyzed retrospectively and their CT and MRI results were analyzed. Results CT manifestation was like wormy appearance,cortical bones were vague and thickened,and some proliferated by sclerosis, different bone destructions might appeared in different parts in a one case.MRI manifestation was disappearance of high bone marrow signal and replaced by medium signal of tumor, and enhanced obviously by enhancement scanning.Among the 29 patients,10 cases were detected by CT with detection rate of 34.5%,in which the single part were 3 cases（ac- counted for 10.3%,the multiple parts were 7 cases （accounted for 24.1%）.21 cases were detected by MRI with detection rate of 72.4%,in which the single part were 8 cases （accounted for 27.6%）,the multiple parts were 13 cases（accounted for 44.8%）,the differences of the detection result between the two groups were all tatistically significant （P〈0.O5）.The most parts of bone invasion detected by CT were conical tip and then pterygoid lamina while the most parts of bone in- vasion detected by MRI were conical tip and then ramp bone. Conclusion The diagnosis of MRI can improve the accu- rate diagnosis rate of skull base bone invasion of NPC for an early diagnosis and timely treatment.h has certain value in location of skull base bone invasion of NPC and choose of treatment plans.