Ng S H, Chang T C, Ko S F, Yen P S, Wan Y L, Tang L M, Tsai M H
Department of Diagnostic Radiology, Chang Gung Memorial Hospital, Tao Yuan, Taiwan, R.O.C.
Neuroradiology. 1997 Oct;39(10):741-6. doi: 10.1007/s002340050499.
Precise assessment of the extent of nasopharyngeal carcinoma (NPC) represents the basic step towards optimal treatment. We compared the capacity of CT and MRI in assessing the extent of NPC in 67 patients. MRI was superior to CT in demonstrating lesions in the retropharyngeal node, skull base, intracranial area, carotid space, longus colli muscle and levator palatini muscle. Of 25 cases in which retropharyngeal adenopathy was recognised only on MRI, seven had been reported as showing oropharyngeal involvement and 18 as primary extension to the carotid space on CT. MRI showed skull-base involvement in 40 patients compared with 27 on CT and intracranial involvement in 38 patients versus 24 on CT. There was not a single case in which skull base invasion was seen on CT but not on MRI. MRI enabled improved recognition of tumour infiltration of longus colli muscles (34 cases compared with 15 on CT). It allowed us to clarify 12 questionable sinonasal opacities on CT. Overall, T-staging was changed in 18 of 67 patients (26.9%), including upstaging in 15 cases and down-staging in 3 cases, after comparing CT with MRI. The nodel status was changed from negative on CT to positive on MRI in 4 of 67 patients (6%). We believe that MRI allows more accurate evaluation of the extent of NPC than CT and should be the primary mode of investigation.
准确评估鼻咽癌（NPC）的范围是实现最佳治疗的基本步骤。我们比较了CT和MRI对67例患者鼻咽癌范围的评估能力。在显示咽后淋巴结、颅底、颅内区域、颈动脉间隙、颈长肌和腭提肌的病变方面，MRI优于CT。在仅MRI发现咽后淋巴结肿大的25例病例中，7例在CT上报告为口咽受累，18例报告为肿瘤主要向颈动脉间隙扩展。MRI显示40例患者有颅底受累，而CT为27例；MRI显示38例患者有颅内受累，CT为24例。没有一例在CT上显示颅底侵犯而MRI未显示的情况。MRI能更好地识别颈长肌的肿瘤浸润（34例，CT为15例）。它使我们能够澄清CT上12例可疑的鼻窦混浊。总体而言，在将CT与MRI进行比较后，67例患者中有18例（26.9%）的T分期发生了改变，其中15例上调分期，3例下调分期。67例患者中有4例（6%）的淋巴结状态从CT上的阴性变为MRI上的阳性。我们认为，MRI比CT能更准确地评估鼻咽癌的范围，应作为主要的检查方式。
