鼻咽癌海绵窦受侵的临床及影像学分析

目的 探讨鼻咽癌海绵窦受侵的临床及影像学特点.方法 回顾分析1998年～2003年我院诊治的鼻咽癌海绵窦受侵患者72例.全部经CT和MRI诊断,比较CT与MRI在海绵窦受侵中的诊断差异.分析头痛、颅神经症状及颅底骨破坏与海绵窦受侵的关系.结果 72例中,MRI均能显示海绵窦受侵,CT有12例不能确诊.全组伴头痛59例(81.9%),其中与受侵海绵窦同侧52例(88.1%);合并前组颅神经症状62例(86.1%),其中两对以上的40例(64.5%);颅底骨破坏70例(97.2%),其中两个部位以上的65例(92.8%).结论 MRI较CT能更早期准确诊断鼻咽癌海绵窦受侵.头痛和颅神经症状是海绵窦受侵的主要指征.

Clinical and imaging analysis of 72 patients with cavernous sinus invaded by nasopharyngeal carcinoma

Objective To investigave the clinical and imaging features of cavernous sinus invaded (CSI) by nasopharyngeal carcinoma (NPC). Methods From 1998 to 2003, 72 patients with CSI diagnosed by computed tomography (CT) and magnetic resonance imaging (MRI) were analyzed retrospectively. The diagnostic diversity of CT and MRI in CSI was compared. The relationship between symptoms of headache,cranial nerve and skull base bone invasion and CSI was analyzed. Results Twelve patients were negative on CT,but positive on MRI image. Headache occurred in 59 cases (81.9%)(52 cases with ipsilateral CSI,88.1%).Frontal group cranial nerve symptom occurred in 62 cases (86.1%)(most frequent involvement for abducent nerve in 40 cases,64.5%).Skull base bone lesion occurred in 70 cases (97.2%)(over two sites in 65 cases,92.8%).Conclusion MRI is superior to CT in detectiing CSI by NPC. Headache and the symptoms of the cranial nerve are the major symptoms caused by CSI.