HOW DOES MAGNETIC RESONANCE IMAGING INFLUENCE STAGING ACCORDING TO AJCC STAGING SYSTEM FOR NASOPHARYNGEAL CARCINOMA COMPARED WITH COMPUTED TOMOGRAPHY?
HOW DOES MAGNETIC RESONANCE IMAGING INFLUENCE STAGING ACCORDING TO AJCC STAGING SYSTEM FOR NASOPHARYNGEAL CARCINOMA COMPARED WITH COMPUTED TOMOGRAPHY?
复制标题
DOI：
10.1016/j.ijrobp.2008.03.017
复制
发表时间：
2008-12-01
影响因子：
7
通讯作者：
Ma, Jun
中科院分区：
文献类型：
--
作者：
Liao, Xin-Biao;Mao, Yan-Ping;Ma, Jun
用途：目的：分析磁共振成像（MRI）与计算机断层扫描（CT）对鼻咽癌（NPC）分期的影响程度和方式。方法：回顾性分析420例初诊鼻咽癌患者的MRI、CT扫描及病历资料。所有患者的肿瘤均按照美国癌症联合委员会第6版分期系统进行分期。显著差异CT与MRI在显示口咽部受累方面有显著性差异（p < 0.05）（CT，25.0% vs. MRI，14.5%），椎前肌（CT，18.4% vs. MRI，36.0%），咽旁间隙（CT，82.6% vs. MRI，68.8%），颅底（CT，31.0% vs. MRI，52.6%），蝶窦（CT，13.6% vs. MRI，16.7%）、筛窦（CT，7.1% vs. MRI，3.3%）、颅内区域（CT，4.8% vs. MRI，16.0%）和咽后淋巴结（CT，52.1% vs. MRI，69.0%）。CT和MRI显示颈淋巴结转移及各节段淋巴结转移的发生率相似。结论：MRI能更准确地显示肿瘤的早期侵犯，更易显示肿瘤的深部浸润，对T期、N期和临床期的诊断率分别为49.8%、10.7%和38.6%。MRI对鼻咽癌T分期和临床分期的影响较大，应优于CT。患者将受益于使用MRI导致的治疗策略的变化。(C)2008年爱思唯尔公司
Purpose: To analyze the degree and pattern of influence of magnetic resonance imaging (MRI) on staging according to the 6th edition of the American Joint Committee on Cancer staging system compared with computed tomography (CT).Methods and Materials: The MRI and CT scans and medical records of 420 consecutive patients with newly diagnosed nasopharyngeal carcinoma (NPC) were analyzed retrospectively. The tumors of all patients were staged according to the 6th edition of the American Joint Committee on Cancer staging system.Results: A significant difference (p < 0.05) was found between CT and MRI in demonstrating involvement in the oropharynx (CT, 25.0% vs. MRI, 14.5%), prevertebral muscle (CT, 18.4% vs. MRI, 36.0%), parapharyngeal space (CT, 82.6% vs. MRI, 68.8%), skull base (CT, 31.0% vs. MRI, 52.6%), sphenoid sinus (CT, 13.6% vs. MRI, 16.7%), ethmoid sinus (CT, 7.1% vs. MRI, 3.3%), intracranial area (CT, 4.8% vs. MRI, 16.0%), and retropharyngeal lymph nodes (CT, 52.1% vs. MRI, 69.0%). The incidence of cervical lymph node metastasis and lymph node metastasis at each level was similar according to CT and MRI. MRI resulted in changes in 49.8% of T stage cases, 10.7% of N stage cases, and 38.6% of clinical stage cases.Conclusion: MRI demonstrated early primary tumor involvement more precisely and deep primary tumor infiltration more easily. The use of MRI caused dramatic changes in the results of the T stage and clinical staging and should be preferred to CT in staging NPC. Patients would benefit from changes in treatment strategies resulting from the use of MRI. (C) 2008 Elsevier Inc.