MRI study on the relationship between the invasion patterns and staging of nasopharyngeal carcinoma
CHEN Yun-bin, FANG Yan-hong, CHEN Ying, LU Tao, CAI Lin-feng, LIAO Jiang, CHEN Jia-you, HU Chun-miao, ZHENG De-chun, XIAO You-ping, PAN Jian-ji
Published 2010-10-10
Cite as Chin J Radiol, 2010,44(10): 1024-1029. DOI: 10.3760/cma.j.issn.1005-1201.2010.10.004
Abstract
Objective To investigate the peri-nasopharyngeal invasion patterns of nasopharyngeal carcinoma (NPC) on MRI and its relationship with tumor staging. Methods One thousand five hundred and seventy-three patients with newly diagnosed NPC which were histo-pathologically proved were retrospectively studied. The MRI manifestations and invasion patterns of the NPCs were elevated according to the 2008 Tstaging system of NPC. Z test was used to analyze the rate of adjacent structures invasion in NPCs. Results The structures invaded by NPCs included pharyngobasilar fascia in 1299 cases (82. 58% ); parapharyngeal space, 1090 ( 69. 29% ); nasal cavities, 304 ( 19. 33% ); oropharynx, 49 ( 3. 12% ); carotid space,514(32. 68% ); medial pterygoid muscle, 661 (42. 02% ); lateral pterygoid muscle, 210( 13. 35% ); skull base bones, 943(59. 95% ); cranial nerves, 630(40. 05% ) and paranasal sinuses, 242 ( 15.38% ). The T-stage distribution was T1, 242 cases ( 15.38% ); T2, 288 ( 18. 31% ); T3, 410 (26. 06% ) and T4,633 (40. 24% ). Among the cases with nasal cavities invasion, 90. 46% (275/304)showed the involvement of the structures seen in T3 or T4 stage, which was found in all cases with oropharynx invasion. In addition,69. 14% (457/661) of cases with medial pterygoid muscle invasion and 92. 15% (223/242) of cases with paranasal sinuses invasion showed the involvement of structures seen in T4 stage. As for the invasion patterns of NPC, the lateral invasion of pharyngobasilar fascia was more frequent than upward invasion of skull base (Z = 14. 025, P < 0. 01 ) and downward invasion of oropharynx ( Z = 45.032, P < 0. 01 ), and the downward invasion of oropharynx was less frequent than upward invasion of skull base ( Z = 34. 301, P < 0. 01 ) and forward invasion of nasal cavities ( Z = 14. 404, P < 0. 01 ). Conclusion NPC has a predilection of lateral invasion rather than upward and downward invasion, and its upward and forward invasion are more common than downward invasion.
Key words:
Nasopharyngeal neoplasms; Magnetic resonance imaging; Neoplasm staging
Contributor Information
CHEN Yun-bin
Department of Radiology, Fujian Tumor Hospital, Fujian Medical University, Fuzhou 350014, China
FANG Yan-hong
Department of Radiology, Fujian Tumor Hospital, Fujian Medical University, Fuzhou 350014, China
CHEN Ying
Department of Radiology, Fujian Tumor Hospital, Fujian Medical University, Fuzhou 350014, China
LU Tao
Department of Radiology, Fujian Tumor Hospital, Fujian Medical University, Fuzhou 350014, China
CAI Lin-feng
Department of Radiology, Fujian Tumor Hospital, Fujian Medical University, Fuzhou 350014, China
LIAO Jiang
Department of Radiology, Fujian Tumor Hospital, Fujian Medical University, Fuzhou 350014, China
CHEN Jia-you
Department of Radiology, Fujian Tumor Hospital, Fujian Medical University, Fuzhou 350014, China
HU Chun-miao
Department of Radiology, Fujian Tumor Hospital, Fujian Medical University, Fuzhou 350014, China
ZHENG De-chun
Department of Radiology, Fujian Tumor Hospital, Fujian Medical University, Fuzhou 350014, China
XIAO You-ping
Department of Radiology, Fujian Tumor Hospital, Fujian Medical University, Fuzhou 350014, China
PAN Jian-ji
Department of Radiology, Fujian Tumor Hospital, Fujian Medical University, Fuzhou 350014, China