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下咽癌颈部及咽后淋巴结转移的CT、MRI分析 被引量:1

CT and MRI analysis of cervical and retropharyngeal lymph node metastasis of hypopharyngeal carcinoma
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摘要 目的探讨CT和MRI对鼻咽癌咽后淋巴结转移的诊断价值和下咽癌区域淋巴结转移特征规律。方法回顾性分析深圳市宝安区人民医院2015年10月至2019年11月收治的93例下咽癌患者,分别接受CT和MRI扫描,比较两种诊断方式的诊断效能和分析下咽癌区域淋巴结转移特征规律。结果MRI在颈动脉间隙和咽喉淋巴结的侵犯显示率明显高于CT(P<0.05),其他区域比较,差异无统计学意义(P>0.05)。MRI在低于0.9 cm的咽喉淋巴结转移显示率高于CT(P<0.05);在0.9 cm以上的显示率比较,差异无统计学意义(P>0.05)。MRI检出42例鼻咽癌咽后淋巴结转移患者类似于原发癌的信号强度,均呈现不均匀信号,其中T1WI为中等信号,而T2WI为不均匀偏高信号,还有7例患者有斑点状高信号影,经增强扫描后,均可观察到显著的不均匀强化。CT扫描观察到淋巴结边缘有清晰结节影,与周围组织有明显界限,经增强扫描后可见显著变化。42例咽喉淋巴结转移患者,有23例淋巴结内存在程度不一坏死,坏死区域出现低密度影,而MRI呈现T1WI低信号和T2WI高信号。坏死组织经CT和MRI增强扫描后,均未见强化,但淋巴结出现环状强化征象。结论在鼻咽癌咽后淋巴结转移的病理筛查中,采取MRI检查,可比CT更准确地筛查出肿瘤转移侵犯范围,可为临床病理诊断和后续治疗提供准确的病理学数据支持。 【Objective】To investigate the diagnostic value of CT and MRI in retropharyngeal lymph node metastasis of nasopharyngeal carcinoma and the characteristics of lymph node metastasis in hypopharyngeal carcinoma region.【Methods】A total of 93 patients with hypopharyngeal carcinoma treated in Shenzhen Bao'an District People's Hospital from October 2015 to November 2019 were retrospectively analyzed.They underwent CT and MRI scans respectively.The diagnostic efficacy of the two diagnostic methods were compared and the characteristics of regional lymph node metastasis of hypopharyngeal carcinoma were analyzed.【Results】MRI showed significantly higher invasion rates in the carotid space and laryngopharyngeal lymph nodes than CT(P<0.05),and there was no significant difference in other regions(P>0.05).The display rate of MRI was significantly higher than that of CT in laryngopharyngeal lymph node metastasis of less than 0.9cm(P<0.05),there was no significant difference in the display rate above 0.9cm(P>0.05).MRI showed that the signal intensity of 42 patients with retropharyngeal lymph node metastasis of nasopharyngeal carcinoma was similar to that of the primary carcinoma,and all of them showed uneven signal intensity,among which T1WI showed moderate signal intensity,while T2WI showed uneven and high signal intensity.There were 7 patients with speckled high signal shadow,and significant uneven enhancement could be observed after enhanced scanning.CT scan observed a clear nodular shadow at the edge of the lymph node,with a clear boundary with the surrounding tissue,and significant changes can be seen after enhanced scan.Of the 42 patients with laryngopharyngeal lymph node metastasis,23 had necrosis of varying degrees in lymph nodes,low density shadow appeared in the necrotic area,and low signal intensity on T1WI and high signal intensity on T2WI were shown on MRI.Contrast-enhanced CT and MRI showed no enhancement in the necrotic tissue,but the lymph nodes showed signs of circular enhancement.【Conclusion】In the
作者 陈宏光 梁久平 赵双全 陈文聪 CHEN Hongguang;LIANG Jiuping;ZHAO Shuangquan;CHEN Wencong(Department of Radiology,Bao'an District People's Hospital,Shenzhen,Guangdong 518101,China;MRI Room,Bao'an District People's Hospital,Shenzhen,Guangdong 518101,China;CT Room,Bao'an District People's Hospital,Shenzhen,Guangdong 518101,China)
出处 《中国医学工程》 2021年第8期10-13,共4页 China Medical Engineering
基金 2020年宝安区医疗卫生基础研究项目(2020JD461)。
关键词 CT MR 下咽癌 咽后淋巴结转移 CT MR hypopharyngeal carcinoma retropharyngeal lymph node metastasis
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