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• Clinical Article •
MRI T staging of nasopharyngeal carcinoma involving the fascial spaces of suprahyoid neck
WANG Wei-ling  ZHOU Yao  WANG Rong-pin  HE Xi  LIU Chang-jie 

DOI:10.12015/issn.1674-8034.2017.05.003.


[Abstract] Objective: To investigate the general invasiveness laws of nasopharyngeal carcinoma (NPC) for fascial spaces of suprahyoid neck and its relationship with T staging by using MRI examination.Materials and Methods: A retrospective analysis of 200 cases of newly diagnosed patients with NPC confirmed by pathology was performed at Guizhou Provincial People's Hospital from July 2013 to March 2016. All the patients underwent plain and enhanced MRI examination. Neoplasm involving the fascial spaces of suprahyoid neck and its relationship with T staging were performed by two experienced radiologists according to the newly revised clinical staging form "2008 staging of NPC" by China Work Committee of NPC.Results: (1) The frequency of neoplasm involving the fascial spaces of suprahyoid neck were the following: pharyngeal mucosa gap (200 cases), parapharyngeal space (180 cases), chewing gap (139 cases), retropharyngeal space (125 cases), vertebral round gap (119 cases), carotid space (57 cases), parotid space (14 cases), submandibular space (two cases), cheek gap (1 case). Tumors involving the fascial spaces of suprahyoid neck were found to be: invasiveness of lateral parapharyngeal space was more than that of rear retropharyngeal space, invasiveness of rear retropharyngeal space was more than that of lateral to the rear of the carotid space, and invasiveness of bilateral was more than that of unilateral infiltration. (2) Eight cases (4.0%) of NPC were T1 stage and tumors confined to the pharyngeal mucosa gap. Thirty-four cases (17.0%) of tumors, among them 64.7% (22/34) were T2 stage and brokethrough the pharyngobasilar fascia and extent to the parapharyngeal space. Sixty-one cases (30.5%) of tumors were T3 stage, and the frequency of neoplasm involving the fascial spaces of suprahyoid neck were found to be: pharyngeal mucosa gap/parapharyngeal space 100% (61/61), retropharyngeal space 77.0% (47/61), chewing gap 68.9% (42/61), vertebral week gap 67.2% (41/61), carotid space 37.7% (23/61). No neoplasm invasiveness was found in the submandibular space, parotid space, cheek and neckgap. Ninety-seven cases (48.5%) of patients were T4 stage and the frequency of neoplasm invasiveness were found to be: pharyngeal mucosa clearance/swallow next to the gap/chewing gap of 100% (97/97), retropharyngeal space 80.4% (78 /97), vertebral week gap 76.3% (74 /97), carotid space 35.1% (34/97), parotid gap of 14.4% (14/97), lower jaw gap 2.1% (2/97), cheek gap of 1.0% (1/97). No neoplasm invasiveness was found in the rear neck gap. (3) The unilateral and bilateral invasion of the nasopharyngeal carcinoma to the surrounding space: 30.2% (58/192), 69.8% (134/192).Conclusions: Nasopharyngeal carcinoma has an attribute of involving various fascial spaces of suprahyoid neck. Parapharyngeal spaces invasiveness were found to be the highest one, and the posterior cervical space were found to be the only free space of invasiveness. Tumor involving the fascial spaces of suprahyoid neck may be summerized as:invasiveness of lateral spacesis more than that of posterior spaces, and followed by lateral to rear spaces, and bilateral space invasiveness is more than unilateral infiltration.
[Keywords] Fascial spaces of suprahyoid neck；Nasopharyngeal neoplasms；Magnetic resonance imaging

WANG Wei-ling Department of Radiology, Guizhou Provincial People's Hospital, Guiyang 550002, China

ZHOU Yao Department of Radiology, Guizhou Provincial People's Hospital, Guiyang 550002, China

WANG Rong-pin* Department of Radiology, Guizhou Provincial People's Hospital, Guiyang 550002, China

HE Xi Department of Radiology, Guizhou Provincial People's Hospital, Guiyang 550002, China

LIU Chang-jie Department of Radiology, Guizhou Provincial People's Hospital, Guiyang 550002, China

*Correspondence to: Wang RP, E-mail: wangrongpin@126.com

Conflicts of interest   None.

Received  2017-01-31
Accepted  2017-03-26
DOI: 10.12015/issn.1674-8034.2017.05.003
DOI:10.12015/issn.1674-8034.2017.05.003.

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