磁共振三维扰相位快速梯度回波在鼻咽癌分期扫描中的应用价值

目的研究三维磁共振增强扫描在鼻咽癌临床分期诊断和疗效判断中的价值。方法对36例鼻咽癌患者除常规MR平扫外,同时进行AxT1fs增强扫描和三维扰相位快速梯度回波增强扫描(3DLAVA)。结果 AxT1fs增强与3D(LAVA)增强显示病灶的检出率分别为:颈部淋巴结转移75%、80.6%;咽后淋巴结72.2%、72.2%;颈椎转移8.3%、8.3%;累及颅底41.7%、44.4%;海绵窦19.4%、25%;蝶窦11.1%、11.1%;咽旁间隙27.8%、30.6%;翼内、外肌36.1%、36.1%;翼腭窝8.3%、8.3%;鼻腔11.1%、11.1%;口咽19.4%、19.4%;脑膜5.6%、5.6%;眼球2.8%、2.8%。结论 3DMRI扫描主要观察鼻咽肿瘤侵犯范围、海绵窦受累情况,追踪血管与肿瘤的关系以及颈部淋巴结的显示尤为突出;同时扫描速度快等特点。

The clinical application of 3D FSPGR sequence in the staging of nasopharyngeal carcinoma

Objective To study the feasibility and value of the MR Three-Dimensional Fast Spoiled Gradient Recalled（3DFSPGR） contrast enhanced sequence in the staging of nasopharyngeal carcinoma and evaluation of therapeutic assessment.Methods 36 nasopharyngeal carcinoma patients received both enhanced conventional axial T1 fs scan and 3DFSPGR（also known as 3D Liver Acceleration Volume Acquisition,LAVA） sequence,and compared this two sequences.Results The relevance ratio in displaying the malignant lesions between T1 and 3DFSPGR were as follow：the cervical lymph node metastasis75%、80.6%;retropharyngeal lymph node metastasis 72.2%、72.2%;cervical vertebra metastasis 8.3%、8.3%;skull base involvement 41.7%、44.4%;cavernous sinus 19.4%、25%;sphenoid sinus 11.1%、11.1%;parapharyngeal space 27.8%、30.6%;pterygoid muscle 36.1%、36.1%;pterygopalatine fossa 8.3%、8.3%;nasal cavity 11.1%、11.1%;oropharynx 19.4%、19.4%;meningitis 5.6%、5.6%;the eyeball 2.8%、2.8%.Conclusion In the MR scan of nasopharyngeal carcinoma patients,compared the conventional T1 fs sequence,3D LAVA can provide nice observation of surrounding invasion,especially in tracking of the blood vessels and displaying of lymph nodes metastasis,accompanying with a shorter scan time.