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Objective: We compared positron emission tomography (PET) using 18-fiuoro-2-deoxyglucose (FDG), enhanced computed tomography (CT) and magnetic resonance imaging (MRI) in detecting skull base invasion of nasopharyngeal car-cinomas (NPC) and to evaluate the value of these three methods in determining the existence of skull base invasion of naso-pharyngeal carcinomas. Methods: The images of enhanced CT, MRI and PET-CT scans, performed at intervals ≤ 20 days on 57 NPC patients from 7 2004 to February 2007, were selected and reviewed. The endpoints of the comparison were sensitivity, specificity, accuracy, positive predictive value (PPV) and negative predictive value (NPV) of Enhanced CT, MRI and PET-CT, based on histopathologic findings or clinical imaging follow-up for at least 6 months. Results: For detecting skull base invasion of NPC, the sensitivity of enhanced CT, MRI and PET-CT were 68.18%, 84.09%, 97.67% respectively; sped-ficity were 76.92%, 69.23%, 57.14% respectively; accuracy were 70.18%, 80.7%, 87.72% respectively; PPV were 90.9%,90.24%, 87.5% respectively; NPV were 41.67%, 56.25%, 88.89% respectively. Conclusion: PET-CT has obvious advan-tages in sensitivity over CT (P < 0.05) and MRI, better than the two methods in accuracy and NPV and 5 be more valuable for new patients in detecting skull base invasion of NPC patients.