MRI联合CT诊断鼻咽癌颅底转移

目的:探讨MRI联合CT诊断鼻咽癌颅底转移的价值。方法:选取2006年8月至2013年8月经病理证实为鼻咽癌的患者50例，全部患者治疗前均行CT及MRI检查，分析鼻咽癌颅底转移的CT及MRI影像学表现，评价联合应用CT/MRI对鼻咽癌颅底转移诊断的价值。结果:CT示颅底骨质侵犯30例，MRI扫描示颅底侵犯39例，其中5例MRI扫描发现斜坡、蝶骨翼和蝶骨体早期骨髓浸润，而CT检查表现正常。另外1例MRI见肿瘤沿三叉神经向颅内侵犯，而CT未见明确的卵圆孔破坏。两种影像学方法的检出率存在显著性差异（P<0.05）。结论:CT与MRI均可显示鼻咽癌颅底转移，MRI对颅底组织侵犯更加敏感，二者联合有助于提高诊断的准确性。

Combination of magnetic resonance imaging and computed tomography in assessment of skull base encroachment in nasopharyngeal carcinoma

Objective:To investigate the CT and MRI imaging features and assessment in skull base erosion of nasopharyngeal carcinoma (NPC).Methods:Fifty cases of NPC proved by pathology were collected and retrospectively reviewed,which underwent both CT and MRI scan.CT and MRI images were analyzed by radiologists,and the value was explored about CT and MRI combination in improving relevance rate of skull base erosion.Results:MRI discovered 7 cases of skull base encroached more than CT (39 vs 30).MRI revealed bone marrow infiltration in clivus,basilar and wing sphenoid bone metastasis in 5 cases,while CT displayed no abnormality.In addition,MRI revealed nasopharyngeal carcinoma tissue infiltrated along trigeminal nerve (1 case),yet CT revealed no destroy in oval foramen.There was significant difference in relevance rate between CT and MRI （P<0.05）.Conclusion:Both CT and MRI can reveal the skull base encroaches by NPC.MRI is more sensitive than CT in detecting the skull base encroachment.The combined application of CT and MRI will improve the accuracy of diagnose.