本文選題：鼻咽癌 + 磁共振成像��； 參考：《暨南大學》2011年碩士論文

【摘要】：目的 探討正常中顱窩底下面自然通道在MRI上的影像解剖學特點和鼻咽癌侵犯顱底自然通道的影像特征。 方法 1、本研究通過對60例顱底檢查正常者行MRI掃描,獲得顱底下面自然孔卵圓孔、圓孔、棘孔、破裂孔、翼腭窩及翼管的橫斷面T1WI、T2WI圖像及冠狀面T2WI圖像,觀察相關自然孔形態(tài)并測量其相關徑值,相關自然孔測量值性別及側別間比較采用t檢驗,統(tǒng)計學分析采用SPSS13.0軟件,P值小于0.05認為相關測量值間差別有統(tǒng)計學意義。 2、連續(xù)收集154例在本院行放療前MRI檢查且獲得活檢病理證實的鼻咽癌病例,兩名醫(yī)師分析其中有相關自然孔侵犯的影像資料,并對結果意見達成一致,探討鼻咽癌對這些常見自然通道侵犯特征。 結果 1、卵圓孔在橫斷面上形態(tài)變異較大,多呈卵圓形,內(nèi)容物在T1WI呈等信號、T2WI呈略高信號,卵圓孔最大徑和最小徑平均值分別為：6.5±0.8mm、3.8±0.7mm。圓孔在橫斷面呈管型或孔型,冠狀面上多為類圓形,內(nèi)容物在T1WI呈等信號、T2WI呈略高信號,其平均內(nèi)徑、長度分別為：2.5±0.5mm、4.9±1.6mm。棘孔較小,50%棘孔在MRI橫斷面上能夠較好顯示,橫斷面上多呈圓形,冠狀面呈略彎曲管道,測量棘孔最大值分別約3.2mm,最小值約1.7mm,中央內(nèi)容物在T1WI、T2WI呈低信號或無信號。翼管多呈較直細管狀結構,橫斷面呈圓形,64%翼管能夠很好顯示,內(nèi)容物在T1WI呈等信號、T2WI呈略高信號,翼管長度最大值約為17.8mm、最小值約為10.1mm,前口最大值約為4.2mm、最小值約為1.0mm,后口最大值約為2.6mm、最小值約為1.0mm。翼腭窩在不同層面大小及形態(tài)有一定變化,經(jīng)翼板融合部、翼突基底部、翼管及圓孔四個層面測量其最大前后徑分別約：2.9±1.0mm、2.4±0.5mm、3.8±0.9mm、3.4±1.0mm,內(nèi)容物在T1WI及T2WI上呈高信號。破裂孔是由蝶骨、枕骨斜坡及顳骨巖尖圍成骨性孔道,內(nèi)容物在T1WI、T2WI上呈低信號,三邊邊長分別約：8.1±1.7mm、13.8±3.0mm、12.1±2.3mm。統(tǒng)計分析表明,卵圓孔、圓孔、翼腭窩及破裂孔在左右側別及性別無統(tǒng)計學差異(P值均大于0.05)。 2、154例鼻咽癌患者中MRI發(fā)現(xiàn)有顱底自然通道破壞的病例有75例(48.7%),卵圓孔24例、圓孔15例、翼腭窩55例、翼管66例、破裂孔47例、棘孔2例,其中單一自然通道受累11例,兩個以上自然通道同時受累64例。鼻咽癌侵犯顱底自然孔形式主要表現(xiàn)為骨質破壞、沿自然孔蔓延、沿神經(jīng)侵犯及腫瘤直接侵犯等形式。 3、MRI檢查發(fā)現(xiàn)顱底腦膜侵犯的病例有26例,在MRI上主要表現(xiàn)硬膜增厚,增強明顯強化,其中經(jīng)卵圓孔、破裂孔、圓孔途徑腦膜侵犯病例分別為：22例、16例、9例,以卵圓孔居多。 結論 1、MRI多參數(shù)、多層面成像能較為清楚、直觀顯示中顱窩底下面部分自然通道的正常形態(tài)特征,尤其是卵圓孔、圓孔、翼腭窩及破裂孔結構,獲得了相關統(tǒng)計學資料,有助于顱底病變影像診斷。 2、鼻咽癌容易以不同方式侵犯顱底下面自然通道,如卵圓孔、圓孔、翼管、棘孔、破裂孔及翼腭窩等這些重要結構,并進入顱內(nèi)。MRI能夠較好顯示鼻咽癌顱底自然孔的侵犯,對鼻咽癌分期及診斷有重要幫助。
[Abstract]:objective
Objective to investigate the imaging features of natural passages below the middle cranial fossa on MRI and the imaging features of nasopharyngeal carcinoma invading the natural passages of the skull base.
Method
1, in this study, 60 cases of normal cranial base examination were performed MRI scan to obtain the natural orifice of oval hole, circular hole, spinous hole, fracture hole, T1WI, T2WI image and coronal T2WI image of the pterygopalatine fossa and pterygus, and to observe the related natural pore shape and measure the relative diameter of the skull base, and the relative natural pore measurements were compared with t. Statistical analysis using SPSS13.0 software, P value less than 0.05 considered that the difference between the relevant measurement values were statistically significant.
2, 154 cases of nasopharyngeal carcinoma were collected before the MRI examination and confirmed by biopsy pathology in our hospital. Two doctors analyzed the images of the related natural hole invasion, and agreed on the results, and explored the characteristics of the nasopharyngeal carcinoma to these common natural channels.
Result
1, the morphological variation of the oval hole on the cross section is larger, mostly oval, content in T1WI, T2WI slightly high signal, the average value of the maximum diameter and the minimum diameter of the oval hole is 6.5 + 0.8mm, 3.8 + 0.7mm. round holes are tube type or pass in the cross section, the coronal surface is mostly round, the content is in T1WI, and the T2WI is slightly high signal. The average inner diameter is 2.5 + 0.5mm, 4.9 + 1.6mm. spinous pore smaller, 50% spinous holes can be shown better on the MRI cross section, the cross section is more circular, the coronal face is slightly curved pipe, the maximum value of the spinous hole is about 3.2mm, the minimum value is about 1.7mm, the central content is T1WI, T2WI shows low signal or no signal. The wing tube is more straight tube. The cross section is round, and the 64% wing tube can be displayed well, the content is in T1WI, T2WI is slightly high signal, the maximum value of the length of the wing tube is about 17.8mm, the minimum value is about 10.1mm, the maximum value of the front mouth is about 4.2mm, the minimum value is about 1.0mm, the maximum value of the back mouth is about 2.6mm, the minimum value is about the size and shape of the 1.0mm. wing and palate fossa at different levels and forms. The maximum front and back diameters of the wing plate fusion section, the base of the pterygwing, the wing tube and the round hole are measured in four aspects: 2.9 + 1.0mm, 2.4 + 0.5mm, 3.8 + 0.9mm, 3.4 + 1.0mm, and the contents are high signal on T1WI and T2WI. The fracture hole is composed of the sphenoid bone, the occipital slope and the temporomandibular apex, and the contents are low in T1WI and T2WI. The number and three side edge length were about 8.1 + 1.7mm, 13.8 + 3.0mm, and 12.1 + 2.3mm. statistical analysis showed that the oval hole, round hole, pterygopalatine fossa and ruptured hole had no statistical difference between the left and right side and the sex (the P value was greater than 0.05).
In 2154 cases of nasopharyngeal carcinoma, there were 75 cases (48.7%), 24 cases of oval foramen, 15 cases of round hole, 55 cases of pterygopalatine fossa, 66 cases of pterygopalatine fossa, 66 cases of pterygopalatine, 47 cases of ruptured holes and 2 cases of spinous holes, of which the single natural channel was 11 cases, and more than two natural passages were involved in 2154 cases. The main form of the nasopharyngeal carcinoma invasion of the skull base was bone mainly manifested by the bone. Mass destruction, spreading along natural pores, along nerve invasion and direct invasion of tumors.
3, 26 cases of skull base meningeal invasion were found by MRI examination. The main manifestations of MRI were the thickening of the dura and enhanced enhancement. The cases of meningoencephalitis through the foramen ovale, the perforated hole and the circular hole approach meningoencephalitis were 22 cases, 16 cases and 9 cases, with the most of the oval foramen.
conclusion
1, MRI multi parameters, multi-layer imaging can be more clear, intuitively display the normal morphological characteristics of some natural channels below the bottom of the middle cranial fossa, especially the oval hole, round hole, pterygopalatine fossa and rupture pore structure, which can help to diagnose the image of skull base lesions.
2, nasopharyngeal carcinoma can easily invading the natural passages below the base of the skull, such as foramen ovale, round hole, pterygoid, spinous hole, ruptured hole and pteropalatine fossa and so on, and entering the intracranial.MRI can better display the invasion of the natural hole of the skull base of nasopharyngeal carcinoma, which is of great help to the staging and diagnosis of nasopharyngeal carcinoma.
【學位授予單位】：暨南大學
【學位級別】：碩士
【學位授予年份】：2011
【分類號】：R739.63

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