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[目的]比较MRI与CT对鼻咽癌侵犯范围检查的差异性和对T分期的影响。[方法]回顾性分析84例治疗前同时或短时间内(不超过2周)行CT和MRI检查并经病理活检证实是鼻咽癌的患者资料,用χ2检验比较两种检查方法对各解剖部位的检出率。按’92鼻咽癌分期标准,分别以CT加临床体检和MRI加临床体检对患者进行临床分期,用χ2检验比较这两种方法划分的各期病例数的分布情况。[结果]CT和MRI诊断颅底骨质破坏的发生率分别为11.9%和41.7%,两种检查方法比较有显著性差异(χ2=18.970,P=0.000)。CT和MRI诊断海绵窦受侵犯的发生率分别为8.3%和20.2%,两种检查方法比较差异有显著性(χ2=4.861,P=0.027)。对于T分期,用CT和MRI划分的各期病例数分布情况比较有显著性差异(χ2=16.416,P=0.001)。有31例(36.9%)在CT与MRI之间发生了T分期改变,MRI所划分的中晚期患者(Ⅲ期和Ⅳa期)比CT增多。[结论]MRI对鼻咽癌侵犯颅底骨质和海绵窦的检出率高于CT。MRI可使鼻咽癌的T分期升级。
[Objective] To compare the differences between MRI and CT in examining the extent of nasopharyngeal carcinoma invade and the impact on T staging. [Methods] A total of 84 patients with nasopharyngeal carcinoma confirmed by pathology and biopsy before or short-term (less than 2 weeks) before the treatment were retrospectively analyzed. The results ofχ2 test were compared between the two methods for anatomy The detection rate of the site. According to the ’92 nasopharyngeal carcinoma staging criteria, clinical staging was performed with CT plus clinical examination and MRI plus clinical examination, and the distribution of the number of cases by these two methods was compared by χ2 test. [Results] The rates of CT and MRI in diagnosis of skull base bone destruction were 11.9% and 41.7%, respectively. There was significant difference between the two methods (χ2 = 18.970, P = 0.000). The incidences of CT and MRI diagnosis of cavernous sinus invasion were 8.3% and 20.2%, respectively. There was significant difference between the two methods (χ2 = 4.861, P = 0.027). For T staging, the number of cases by CT and MRI distribution of the number of cases were significantly different (χ2 = 16.416, P = 0.001). Thirty-one (36.9%) patients had a T-staging change between CT and MRI, with a higher number of patients with advanced disease (stage III and IVa) than those with CT. [Conclusion] The detection rate of MRI on nasopharyngeal carcinoma invading the skull base and the cavernous sinus is higher than that of CT. MRI can upgrade the T stage of nasopharyngeal carcinoma.