The Coronal Section Study of Computed Tomography in the Intracranial Invasion by Nasopharyngeal Carcinoma

電腦斷層攝影冠狀切面對鼻咽癌顱內侵犯的研究

黃國茂(Kou-Mou Huang) ； 徐劍耀(Jane Chien-Yao Hsu) ； 黃淑珍(Shu-Chen Huang) ； 杜詩綿(Shih-Mien Tu)

《中華放射線醫學雜誌》 7卷3期 (1982/09) Pp. 177-194

摘要

放射線攝影技術，諸如頭顱的攝影、鼻咽腔造影術及多面斷層攝影等，在鼻咽癌的診斷上，已有很大的幫助。但對於柔軟組織受腫瘤侵犯的偵測，還不能令人滿意。特別在顱內方面及是否侵入腦組織？更覺技窮。電腦斷層攝影冠狀切面的檢查，輔以對比劑加強顯影的幫忙，能夠簡易地顯示腦組織被腫瘤的侵犯，特別對於不易做診斷的靠近腦子基部的病變，更有幫助。在此系列，常見到腫瘤直接破壞顱骨底部的中腦窩、蝶骨及枕底骨等，成為一條鼻咽癌顱內侵犯主要的路錢。也常看到，可以沒有骨頭的破壞，而腫瘤經由顱底的孔裂或神經、血管的通道而進入顱內。鼻咽癌顱內的侵犯，最常見發生在中腦窩，其次為後腦窩，很少看到侵犯前腦窩，因為硬腦膜是一道很好的屏障，所以大部份侵入顱內的鼻咽癌，儘止於硬腦膜外的蔓延。冠狀切面檢查能夠清楚地表現鼻咽癌入侵顱內的路线，及腫瘤在頭顱底內外的關係。它有助於鼻咽癌電療的計劃，同時，又是在療效及腫瘤再發的觀測上，最具俾益。

並列摘要

The radiographic technics for the diagnosis of NPC (nasopharyngeal carcinoma) have been well established known as plain skull films, nasopharyngography and polytomography etc., but still not be satisfied to demonstrate the soft tissure involvement by the tumor, especially in the intracranial. The use of the coronal section study of computed tomography with the help of enhancement by contrast medium can make easier detect the brain invasion, particularly the lesion is near the brain base. In this series, it is often seen that direct bone destruction of middle cranial fossa, the sphenoid and the basioccipit etc. at the skull base as a main route of intracranial invasion by NPC. Sometimes, it may have not bone destruction, but the lesion can go through the foramina, fissures and jugular fossa etc. into the intracranial at the skull base. The intracranial involvement by NPC is in order of frequency the middle cranial fossa, the posterior cranial fossa and very rare the anterior cranial fossa. In this tudy, it is found that the dura is a very good barrier, the most intracranial lesions of NPC are just extradurafly involved. The coronal section study makes clear that the route of intracranial invasion as well as the relationship between the extracranial and intracranial components of the lesion, which is helpful for the therapeutic planning. In the mean time, it is the best way to evaluate the effect of the treatment and tumor recurrence.

並列關鍵字

CT computed tomography ； Coronal section ； NPC nasopharyngeal carcinoma ； O-M line orbito-meatal line ； CNS central nervous system