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目的探讨咽旁间隙移位方向及肿瘤MRI信号特点对病变定位、定性的价值。方法回顾性分析经病理确诊的累及咽旁间隙肿瘤76例,其中恶性肿瘤51例,良性肿瘤25例。结果扁桃体肿瘤和鼻咽癌使茎突前间隙外移,腮腺肿瘤使茎突前间隙向前内移位,或(和)颈动脉鞘区后移。颈动脉鞘区交感神经鞘瘤使颈内动、静脉向前外侧移位,迷走神经鞘瘤使颈内动、静脉明显分离,颈动脉体瘤使颈内、外动脉分叉角增大,颈静脉球瘤使血管向前外侧移位,转移淋巴结使颈内动、静脉向前内侧移位。25例良性肿瘤边界清楚,其中9例信号均匀;51例恶性肿瘤中,19例边界模糊,15例信号欠均匀。茎突前间隙脂肪消失或不连续6例均为恶性肿瘤,肿瘤边界较清但颈部淋巴结肿大符合淋巴结转移诊断标准2例及颈内动、静脉被肿瘤包绕3例,病理证实亦为恶性肿瘤。结论咽旁间隙移位方向及肿瘤MRI信号特点对头颈部肿瘤的定位、定性具有重要的价值。
Objective To explore the direction of parapharyngeal space shift and the MRI signal characteristics of tumor positioning and characterization. Methods A retrospective analysis of pathologically confirmed parapharyngeal space involving 76 cases of tumor, including 51 cases of malignant tumors, 25 cases of benign tumors. Results Tonsil tumors and nasopharyngeal carcinoma caused anterior shift of the styloid process, and the parotid tumor shifted the anterior gap of the styloid process forward or (and) posterior to the carotid sheath. Sympathetic schwannoma of the carotid sheath so that the internal carotid artery and vein shift to the anteromedial, vagus nerve sheath tumor so that the internal carotid artery and vein were significantly separated, carotid body tumor to the internal carotid body, external artery bifurcation angle increased, the jugular vein Ball tumor to vascular displacement of the anteromedial, lymph node metastasis to the internal carotid artery, medial anterior shift. Among 25 cases of benign tumor, the boundary was clear, of which 9 cases were uniform. In 51 cases of malignant tumors, the boundary of 19 cases was blurred and the signal of 15 cases was not uniform. The fat in the anterior gap of the styloid process disappeared or discontinued in 6 cases, all of which were malignant tumors. The tumor border was clear but the cervical lymph node enlargement was consistent with the diagnostic criteria of lymph node metastasis in 2 cases and the carotid artery and vein were surrounded by the tumor in 3 cases. Malignant tumor. Conclusion The shift of parapharyngeal space and MRI signal characteristics of tumor have important value for the localization and characterization of head and neck cancer.