48例咽旁隙肿瘤的影像学检查及其临床意义

目的 通过对48例咽旁隙肿瘤的影像学特点进行分析,提高咽旁隙肿瘤的诊断准确率,进一步指导治疗方案和手术入路的选择。 方法 收集2016年1月—2020年4月蚌埠医学院第一附属医院影像科和耳鼻咽喉头颈外科经病理明确诊断的咽旁隙肿瘤患者48例。36例患者术前行CT检查(其中8例单独行CT检查,28例患者同时行CT、MRI检查),40例患者术前行MRI检查(其中12例单独行MRI检查,28例患者同时行CT、MRI检查),结合影像学特点初步明确肿瘤来源,并根据肿瘤影像学特点对其性质进行判断,并统计其与术后大体病理的符合率。 结果 CT和MRI检查有助于判断肿瘤的来源、位置、大小、边界以及与周围重要解剖结构的关系,CT联合MRI检查较单独行CT检查符合率高(χ2=7.365,P=0.007);CT联合MRI检查较单独行MRI检查符合率高(χ2=6.160,P=0.013)。 结论 CT或(和)MRI的检查可初步明确肿瘤的性质和所在部位及来源,CT联合MRI检查咽旁隙肿瘤较单独应用CT或MRI检查具有更大参考意义。影像学作为一种无创检查对咽旁隙肿瘤的诊断、鉴别诊断有重要作用,同时对治疗方案及手术入路的选择具有临床指导价值。 

Imaging examination and clinical significance of 48 cases of parapharyngeal space tumors

Objective To improve the diagnostic accuracy of parapharyngeal space tumor by analyzing the imaging features of 48 cases in our hospital, and further guide the choice of treatment plan and surgical approach. Methods Total 48 patients with parapharyngeal space tumor were diagnosed by pathology in Department of Imaging and Otorhinolaryngology and Head and Neck Surgery from January 2016 to April 2020. Preoperative CT examination was performed in 36 patients(8 alone, 28 CT and MRI), and MRI in 40 patients(12 alone, 28 CT and MRI). According to the characteristics of imaging, the source of tumor was identified, and its nature was judged according to the characteristics of tumor imaging, and the coincidence rate with postoperative gross pathology was counted. Results CT and MRI examination could help to judge the source, location, size, boundary and relationship with the important anatomical structures around the tumor. The coincidence rate of CT combined with MRI was higher than that of CT alone(χ2=7.365, P=0.007), and the coincidence rate of CT combined with MRI was higher than that of MRI alone(χ2=6.160, P=0.013). Conclusion CT or(and) MRI examination can preliminarily identify the nature, location and source of the tumor. CT combined MRI examination of parapharyngeal space tumor is more important than the application of CT or MRI alone examination. Imaging, as a non-invasive examination, plays an important role in the diagnosis and differential diagnosis of parapharyngeal tumors, and has clinical guiding value in the selection of treatment plan and surgical approach.