咽后椎前区肿瘤及肿瘤样病变的CT、MRI诊断

目的分析咽后椎前区肿瘤的CT和MRI特点,并探讨其临床价值。资料与方法回顾分析经病理证实的18例咽后椎前区肿瘤的CT、MRI特点,着重分析咽后壁、咽后脂肪、椎前肌及椎体的改变。结果18例中,咽后壁肿瘤1例,为神经鞘膜瘤;咽后间隙肿瘤5例,均为鼻咽癌;椎前间隙肿瘤12例,包括脊索瘤7例,脑膜瘤3例,外周原始神经外胚层肿瘤和软组织内动脉瘤样囊肿各1例。咽后壁肿瘤将咽后间隙脂肪推向后方,将椎前肌碾平或推向外侧;咽后间隙肿瘤位于咽后壁和椎前肌之间,将椎前肌推向后或内侧;椎前间隙肿瘤与椎体关系密切,将椎前肌和咽后脂肪推向前方。结论CT、MRI检查有助于判断咽后椎前区肿瘤的起源部位,提高诊断准确性。

The CT and MRI Diagnosis of Primary Tumors Arising from the Region Between Posterior Pharyngeal Wall and Cervical Vertebrae

Objective To analyze CT and MRI findings of tumors arising from the region between posterior pharyngeal wall and cervical vertebrae, and to evaluate their clinic values. Materials and Methods 18 cases of pathologically proven tumors arising from the region between the posterior pharyngeal wall and cervical vertebrae were collected. The CT and MRI features were retrospectively analyzed, and emphasis was put on the alterations of posterior pharyngeal wall, retropharyngeal fat plane, prevertebral muscles, vertebral bodies and carotid sheath. Results Among 18 cases, 1 case of schwannoma arised from the posterior wall of the pharynx. 5 cases of nasopharyngeal carcinomas involved retropharyngeal space. 12 cases arised from prevertebral space, including chordomas in 7 cases, meningiomas in 3 cases, peripheral primary neuroectodermal tumor in 1 case and primary aneurysmal cyst of soft tissue in 1 case. Tumors in the posterior wall of the pharynx pushed retropharyngeal fat plane and prevertebral muscles posteriorly. Tumors in retropharyngeal space pushed prevertebral muscles posteriorly or medially. Tumors in prevertebral space had intimate relationship with vertebral body and pushed prevertebral muscles and retropharyngeal fat plane anteriorly. Conclusion CT and MRI are helpful for defining the origin and diagnosing tumor in the region between posterior pharyngeal wall and cervical vertebrae.