摘要
目的分析鼻咽癌颈部淋巴结转移的CT表现及特点。资料与方法分析1991年至2006年有完整临床及CT资料且经病理证实的鼻咽癌1100例。分析颈部淋巴结的表现,并对相关资料进行统计学处理。结果1100例中1008例(91.64%)有颈部淋巴结转移,其中双侧转移656例(59.64%)。咽后组淋巴结转移737例(67%),颈上深组转移973例(88.45%),颈后三角区转移367例(33.36%)。CT扫描至相应部位发现有淋巴结转移者,颈中深组为630例(71.75%),颈下深组为200例(46.73%),锁骨上区为100例(30.96%)。鼻咽癌可转移至颌下、颏下及腮腺内淋巴结,本组分别为93例(8.45%)、17例(1.55%)及38例(3.45%)。转移淋巴结边缘规则614例(60.91%),边缘不规则394例(39.09%),其中明显侵犯周围结构者仅占70例(6.94%)。增强CT扫描病例中98.50%的淋巴结为轻、中度强化,无强化及明显强化的淋巴结分别为0.69%和0.81%。转移淋巴结中50.60%密度均匀,49.40%内部密度不均匀,有低密度区,其中95例(9.42%)的淋巴结内有大片低密度坏死区,92例(9.13%)淋巴结内呈密度均匀一致的环状低密度区,且内壁规则。结论鼻咽癌多发生颈部淋巴结转移,以咽后组与颈静脉链淋巴结多见。淋巴结边缘规则、增强后呈轻至中度强化、密度大致均匀为鼻咽癌淋巴结转移的典型表现。
Objectives To analyze the CT manifestations of the cervical lymphnodes metastasis of NPC （ nasopharyngeal carcinoma）. Materials and methods CT image data of 1100 patients with histologically proven NPC, who were treated mainly with radiation therapy in our hospital from Jan 1990 to Dec 2005 with intact clinical and imaging files, were retrespectively reviewed by two experienced radiologists. All the data were statistically processed with SPSS 11.5 software. Results Cervical lymph node metastases were present in 1008 cases （91.64%）. Among them, bilateral lymph nodes were involved in 656 cases （ 59.64% ） , retropharyngeal node in 737 （ 67% ） , upper deep jugular chain node in 973 （88.45%）, and posterior cervical triangle in 367 （33.36%）. In the cases in which the following regions were covered by CT scans, such as medium and lower deep jugular chain, supraclavicular area, the incidences of lymphnode metastasis were 71.75%, 46.73% and 30.96% respectively. Lymph nodes in submandibular, submental and parotid regions were affected in the 1100 cases with the proportions as 8.45%, 1.55% and 3.45% separately. The metastatic lymphnodes manifested as well bordered in 60.91%, ill defined in 39.09% , or obvious extending into adjacent tissues in 6.94%. The predominate majority （98.50%） of them showed mild to moderate enhancement on post-contrast CT scans, a few showed remarkable enhancment （0. 81% ） and others showed obvious enhancement （0.69%）. 50.60% of the nodes appeared homogeneous, 49.40% of lesions were heterogeneous with area of low attenuation, in which 9.42% of lesions with large area of necrosis, 9.13% of lesions were displayed as ring - like low attenuation. Conclusions The most common regions of the cervical lymph nodes to be involved by NPC are the retropharyngeal nodes and deep jugular vein chains. The most common appearances of the metastatic lymph nodes of NPC are the enlarged nodes with well defined margin and homogenous density, slight to moderate enhancement on post -contrast CT scans.
出处
《临床放射学杂志》
CSCD
北大核心
2007年第12期1199-1203,共5页
Journal of Clinical Radiology
关键词
鼻咽癌颈部
淋巴结转移体层摄影术
X线计算机
Nasopharyngeal cancer Cervical, lymph node metastasis Tomography, X-ray computed
