论文部分内容阅读
目的探讨鼻咽癌放疗后继发咽旁感染的临床诊断与影像学特点。方法1997年1月至2008年8月共收治鼻咽癌放疗后咽旁感染40例患者,多以颞侧头痛(62.5%)和咽部疼痛(22.5%)为首发症状。鼻咽纤维镜检查其中35例鼻咽黏膜呈不同程度感染、溃疡或坏死样改变(87.5%),5例见结节状肿物。CT与MRI误诊为鼻咽部复发或疑诊复发共14例(35.0%)。全部病例给予抗炎治疗。结果所有病例经抗炎治疗后疼痛症状消失。影像学复查1例鼻咽及咽旁肿物完全消退,30例黏膜感染、溃疡及咽旁软组织增厚范围稍有缩小或变化不大。随访10～150个月,36例无瘤存活至今,4例死于肺炎呼吸衰竭。结论鼻咽癌放疗后咽旁感染,其临床和影像学均易与鼻咽肿瘤复发相混淆。其特点为慢性发病、曾有高剂量放疗史、颞侧或咽部疼痛、鼻咽黏膜感染、溃疡或坏死等。CT与MRI见咽旁可疑肿块影。抗炎治疗效果好。
Objective To investigate the clinical diagnosis and imaging features of secondary pharyngeal infection after radiotherapy of nasopharyngeal carcinoma. Methods From January 1997 to August 2008, 40 patients with parapharyngeal infection after radiotherapy of nasopharyngeal carcinoma were treated. Temporal headache (62.5%) and pharyngeal pain (22.5%) were the first symptoms. Nasopharyngeal fibroids in which 35 cases of nasopharyngeal mucosa showed varying degrees of infection, ulcer or necrosis-like changes (87.5%), 5 cases of nodular tumors. CT and MRI misdiagnosed as nasopharyngeal relapse or suspected relapse a total of 14 cases (35.0%). All cases given anti-inflammatory treatment. Results In all cases, the symptoms of pain disappeared after anti-inflammatory treatment. Imaging resection in 1 case of nasopharyngeal and parapharyngeal mass completely subsided, 30 cases of mucosal infection, ulceration and parapharyngeal soft tissue thickening slightly reduced or little change. Follow-up 10 to 150 months, 36 patients survived so far, 4 patients died of pneumonia and respiratory failure. Conclusion Nasopharyngeal carcinoma parapharyngeal infection after radiotherapy, clinical and imaging are easily confused with nasopharyngeal tumor recurrence. It is characterized by chronic onset, there was a history of high-dose radiation, temporal or pharyngeal pain, nasopharyngeal mucosal infection, ulcers or necrosis. See parapharyngeal suspected CT and MRI shadow mass. Anti-inflammatory treatment is effective.