经颈超声诊断鼻咽癌及咽旁间隙受侵犯的价值

摘要

Objective To investigate the sonographic characteristics and clinical value of neck ultrasound in the diagnosis of nasopharyngeal carcinoma and parapharyngeal space invasion. Methods A total of 45 patients with en-doscopic biopsy-proved nasopharyngeal carcinoma before radiotherapy were investigated. Of the total 65 nasopharyn-geal lesions, there were 25 unilateral and 20 bilateral cases, and 33 lesions of which were involved in parapharyngeal space invasion. Ultrasound and MRI data were collected to analyze the basic characteristics of the lesions in relation to parapharyngeal space, and to compare the positive rate for two methods in the detection of nasopharyngeal carcinoma and parapharyngeal space invasion. Results Ultrasound demonstrated nasopharyngeal anomalies in 60 of 65 lesions, 49 of which showed low echo mass and 11 images appeared nasopharyngeal mucosa thickening. MRI showed anomalies in 63 of 65 lesions, with 46 cases in low echo mass and 17 in nasopharyngeal mucosa thickening. There were no statisti-cal differences between two methods (P>0.05). Neck ultrasound found parapharyngeal space invasion in 28 cases, while 31 cases were seen in MRI. There was also no significant difference between them (P>0.05). Conclusion Ultrasound of neck can be used to observe nasopharyngeal mucosa thickening or mass in nasopharyngeal carcinoma patients, and can be used to determine if the parapharyngeal space was invaded.%目的 探讨经颈超声观察鼻咽癌及咽旁间隙受侵犯的声像图特征及临床应用价值.方法 选取45例经本院鼻内镜活检证实的放疗前鼻咽癌患者,单侧25例,双侧20例,共计65个鼻咽部病灶,其中临床诊断侵犯同侧咽旁间隙33例,收集患者超声及MRI资料,分析上述病灶的基本特征及与咽旁间隙的关系,比较两种检查在鼻咽癌及咽旁间隙受侵犯中的检出率有无差异.结果 65个鼻咽部病变,超声检查发现鼻咽部异常60个,声像图特征表现为低回声肿块49个,鼻咽部黏膜增厚11个;MRI发现63个,其中肿块46个,鼻咽部黏膜增厚17个.两者差异无统计学意义(P>0.05).超声检出咽旁间隙受侵犯28个,MRI检出咽旁间隙受侵犯31个,差异无统计学意义(P>0.05).结论 经颈超声可观察鼻咽癌患者鼻咽部黏膜增厚或肿块,亦可对咽旁间隙是否受侵犯做出判断.