Magnetic resonance imaging of retropharyngeal lymph node metastasis in nasopharyngeal carcinoma: Patterns of spread
Magnetic resonance imaging of retropharyngeal lymph node metastasis in nasopharyngeal carcinoma: Patterns of spread
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DOI：
10.1016/j.ijrobp.2006.05.054
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发表时间：
2006-11-01
影响因子：
7
通讯作者：
Li, Li
中科院分区：
文献类型：
--
作者：
Liu, Li-Zhi;Zhang, Guo-Yi;Li, Li
目的：利用磁共振成像（MRI）研究鼻咽癌（NPC）患者咽后淋巴结（RLN）受累的发生率、分布及扩散模式。方法和材料：回顾性分析275例初诊鼻咽癌患者的MR图像。根据大小标准、淋巴结坏死的存在和囊外扩散，将淋巴结分类为转移性淋巴结。结果：175 名 (63.6%) 患者检测到咽后淋巴结受累。转移性 RLN 在以下部位可见：枕骨，24 个（9.6%）淋巴结； C1，157（62.5%）个节点； C1/2，40（15.9%）个节点； C2，27 个（10.8%）节点； C2/3，1个（0.4%）节点； C3，2 个（0.8%）节点。 215 例淋巴结转移患者中 RLN 受累发生率与颈淋巴结受累发生率相同（81.4% vs. 81.4%）。在口咽部、茎突前咽旁间隙、茎突后咽旁间隙、颈长肌、翼内肌、腭帆提肌、腭帆张肌、11级淋巴结、III级淋巴结和V级淋巴结受累的情况下，转移性RLN的发生率显着较高。 T1、NO 和 I 期疾病中转移性 RLN 的发生率明显较低。相反，TI、2 和 3 之间转移性 RLN 的发生率没有观察到显着差异； N2和N3；或 11、111 和 IV 期疾病。结论：从 C1 到 C3 水平，转移性侧 RLN 的发生率有序降低。转移性 RLN 与早期原发性肿瘤中某些结构的受累以及上颈静脉链（II 级、III 级淋巴结）和后三角区（V 级淋巴结）的淋巴结转移密切相关。 RLN 和颈部 11 级淋巴结似乎都是 NPC 的第一梯队淋巴结。 (c) 2006 爱思唯尔公司
Purpose: To investigate the incidence, distribution, and spread pattern of retropharyngeal lymph node (RLN) involvement in patients with nasopharyngeal carcinoma (NPC) by using magnetic resonance imaging (MRI).Methods and Materials: The MR images of 275 patients with newly diagnosed NPC were reviewed retrospectively. Nodes were classified as metastatic based on size criteria, the presence of nodal necrosis, and extracapsular spread.Results: Retropharyngeal lymph node involvement was detected in 175 (63.6%) patients. Metastatic RLNs were seen at the following levels: occipital bone, 24 (9.6%) nodes; C1, 157 (62.5%) nodes; C1/2, 40 (15.9%) nodes; C2, 27 (10.8%) nodes; C2/3, 1 (0.4%) node; and C3, 2 (0.8%) nodes. The incidence of RLN involvement was equal to the incidence of cervical lymph node involvement (81.4% vs. 81.4%) in 215 patients with nodal metastases. A significantly higher incidence of metastatic RLNs was observed in the presence of oropharynx, prestyloid parapharyngeal space, post-styloid parapharyngeal space, longus colli muscle, medial pterygoid muscle, levator muscle of velum palatini, tensor muscle of velum palatini, Level 11 node, Level III node, and Level V node involvement. A significantly lower incidence of metastatic RLNs was found in T1, NO, and Stage I disease. Conversely, no significant difference in the incidence of metastatic RLNs was observed between TI, 2, and, 3; N2 and N3; or Stage 11, 111, and IV disease.Conclusions: There is an orderly decrease in the incidence of metastatic lateral RLNs from the C1 to C3 level. Metastatic-RLNs associate well with involvement of certain structures in early stage primary tumors and lymph node metastases of the upper jugular chain (Level II, Level III nodes) and the posterior triangle (Level V nodes). Both RLNs and cervical Level 11 nodes appear to be the first-echelon nodes in NPC. (c) 2006 Elsevier Inc.