下咽癌局部侵犯影像学表现及意义.docVIP

下咽癌局部侵犯影像学表现及意义[摘要] 目的 分析下咽癌局部侵犯的影像学表现规律并探讨其临床意义。方法 回顾性分析我院2006年7月～2009年7月收治的68例下咽癌CT/MRI检查结果。结果 梨状窝癌占79.4%,咽后区癌占17.5%,环后区癌占2.9%。梨状窝癌最易侵犯杓会厌皱襞(90.7%)、杓状软骨(83.3%)、喉旁间隙(81.5%)、咽后壁(77.8%)、甲状软骨(70.4%)、会厌前间隙(70.4%),其他较易侵犯的部位有会厌、假声带、声带、环后区及口咽;咽后壁癌易侵犯杓会厌皱襞(100%)、梨状窝(100%)、椎前筋膜(66.7%),颈段食管(66.7%)、杓状软骨(75%)、环状软骨(50%)及口咽(41.7%);环后区癌易侵犯颈段食管、椎前筋膜、梨状窝、环状软骨、咽后壁、杓会厌皱襞、杓状软骨、喉旁间隙、甲状软骨。结论 下咽癌以直接侵犯为主,较少侵犯到鼻咽及颅底,放射野包含鼻咽及颅底可能未必需要。 [关键词] 下咽肿瘤;体层摄影术;X 线计算机;磁共振成像;放射治疗 [中图分类号] R739.63 [文献标识码] A[文章编号] 1673-9701(2010)02-75-03 Imaging Findings of Hypopharyngeal Carcinoma Local Invasion LUO YangkunTAN YanPENG YingWANG JieWEN Hao Radiation Therapy Center,Sichuan Provincial Tumor Hospital,Chengdu 610041,China [Abstract] Objective To analyze the imaging features of hypopharyngeal carcinoma by using CT/MRI and explore their clinical significance. Methods A retrospective analysis was made of CT/MRI examination results of 68 cases of hypopharyngeal carcinoma in our hospital from July 2006 to July 2009. Results Of the 68 cases,54 cases(79.4%)were pyriform sinus carcinoma,12(17.5%) were posterior pharyngeal carcinoma and 2(2.9%) were postcricoid carcinoma. Pyriform sinus cancer most likely invaded the aryepiglottic fold(90.7%),then the arytenoid cartilage(83.3%),paraglotic space(81.5%),posterior wall(77.8%),thyroid cartilage(70.4%) and preepiglottic space(70.4%), and other more easily invaded parts were the epiglottis, false vocal cords, vocal cords, central, postcricoid area and oropharynx. Posterior pharyngeal carcinoma involved aryepiglottic fold(100%),prevertebral fascia(100%),prevertebral fascia(66.7%),esophagus(66.7%),arytenoid cartilage(75%),cricoid cartilage(50%), and oropharynx(41.7%). postcricoid carcinoma usually involved esophagus,prevertebral fascia,prevertebral fascia,cricoid cartilage,posterior wall,aryepiglottic fold,arytenoid cartilage,paraglotic space and thyroid cartilage. Conclusion Hypopharyngeal carcinoma shows a direct invasion through tissues. Nasopharynx and b