From the Departments of Imaging and Interventional Radiology (A.D.K., L.Y.S.W., B.K.H.L., Q.-Y.A.)
From the Departments of Imaging and Interventional Radiology (A.D.K., L.Y.S.W., B.K.H.L., Q.-Y.A.).
AJNR Am J Neuroradiol. 2018 Mar;39(3):515-523. doi: 10.3174/ajnr.A5493. Epub 2017 Dec 28.
MR imaging can detect nasopharyngeal carcinoma that is hidden from endoscopic view, but for accurate detection carcinoma confined within the nasopharynx (stage T1) must be distinguished from benign hyperplasia of the nasopharynx. This study aimed to document the MR imaging features of stage T1 nasopharyngeal carcinoma and to attempt to identify features distinguishing it from benign hyperplasia.
MR images of 189 patients with nasopharyngeal carcinoma confined to the nasopharynx and those of 144 patients with benign hyperplasia were reviewed and compared in this retrospective study. The center, volume, size asymmetry (maximum percentage difference in area between the right and left nasopharyngeal halves), signal intensity asymmetry, deep mucosal white line (greater contrast enhancement along the deep tumor margin), and absence/distortion of the adenoidal septa were evaluated. Differences were assessed with logistic regression and the χ test.
The nasopharyngeal carcinoma center was lateral, central, or diffuse in 134/189 (70.9%), 25/189 (13.2%), and 30/189 (15.9%) cases, respectively. Nasopharyngeal carcinomas involving the walls showed that a deep mucosal white line was present in 180/183 (98.4%), with a focal loss of this line in 153/180 (85%) cases. Adenoidal septa were absent or distorted in 111/111 (100%) nasopharyngeal carcinomas involving the adenoid. Compared with benign hyperplasia, nasopharyngeal carcinoma had a significantly greater volume, size asymmetry, signal asymmetry, focal loss of the deep mucosal white line, and absence/distortion of the adenoidal septa ( < .001). Although size asymmetry was the most accurate criterion (89.5%) for nasopharyngeal carcinoma detection, use of this parameter alone would have missed 11.9% of early-stage T1 nasopharyngeal carcinomas.
MR imaging features can help distinguish stage T1 nasopharyngeal carcinoma from benign hyperplasia in most cases.
磁共振成像（MR）可以检测到内镜检查无法发现的鼻咽癌，但要准确检测局限于鼻咽的鼻咽癌（T1 期），必须将其与鼻咽的良性增生相鉴别。本研究旨在记录 T1 期鼻咽癌的 MR 成像特征，并尝试识别其与良性增生的特征区别。
回顾性分析了 189 例局限于鼻咽的鼻咽癌患者和 144 例良性增生患者的 MR 图像。评估了肿瘤中心位置、体积、大小不对称（左右鼻咽半面积最大百分比差异）、信号强度不对称、深层黏膜白线（肿瘤深部边缘的增强对比度更大）和腺样体间隔的缺失/变形。采用逻辑回归和 χ 检验评估差异。
134/189（70.9%）、25/189（13.2%）和 30/189（15.9%）例鼻咽癌的肿瘤中心位置分别为外侧、中央和弥漫性。183 例累及壁的鼻咽癌中有 180 例（98.4%）存在深层黏膜白线，其中 153 例（85%）存在局部白线缺失。111 例累及腺样体的鼻咽癌中，腺样体间隔缺失或变形 111/111（100%）例。与良性增生相比，鼻咽癌的体积、大小不对称、信号不对称、深层黏膜白线局部缺失和腺样体间隔缺失/变形更为明显（<0.001）。虽然大小不对称是检测鼻咽癌最准确的标准（89.5%），但单独使用该参数会漏诊 11.9%的早期 T1 期鼻咽癌。
MR 成像特征有助于在大多数情况下区分 T1 期鼻咽癌和良性增生。
