[Clinical and MRI diagnosis of nasopharyngeal carcinoma with orbital spread].
OBJECTIVE
To study the routes, clinical manifestations and MRI characteristics of nasopharyngeal carcinoma (NPC) with orbital spread.


METHODS
Twenty (23 eyes) such cases were selected, including 6 (7 eyes) preradiotherapy cases and 14 (16 eyes) postradiotherapy cases. The magnetic resonance imaging (MRI) axial, coronal, sagittal routine procedures and gadolinium-diethylene triamine pentaacetic acid (GD-DTPA) contrast-enhanced scan were performed. Fatty-restraint scan was performed after enhancement only on 3 cases. The diagnosis in all the patients was proved by the biopsy from the nasopharynx.


RESULTS
(1) Single orbit involvement was seen in 17 patients, 12 in the left and 5 in the right orbit. Bilateral orbit involvement was only found in 3 patients. (2) Major clinical manifestations of orbital involvement by NPC included: 13 cases (15 eyes) suffered from decrease of visual acuity, 9 cases (10 eyes) with exophthalmos, 11 patients (12 eyes) with ocular movement disorder, 7 cases (9 eyes) with diplopia and 5 cases (7 eyes) with blepharoptosis. (3) MRI appearances: There were 13 cases (15 eyes) with optic nerve involvement, 9 patients (11 eyes) with abnormalities in extraocular muscle, 8 cases (9 eyes) with retrobulbar tumor and 15 cases (17eyes) with orbital apex and orbital lamina bony involvement. (4) The three main routes for orbital involvement in NPC patients were as follows: (a) through cavernous sinus (the skull base) to superior orbital fissure. (b) through paranasal sinus (particularly the ethmoid sinus). (c) through pterygopalatine fossa to inferior orbital fissure.


CONCLUSIONS
MR imaging is very useful to demonstrate the presence, location and extent of orbital involvement in NPC patients.
Long
W
W
Department of Radiology, Jiangmen Central Hospital, Guangdong Province, Jiangmen 529070, China. jmlws@21cn.com
Wang
L
L
Luo
X
X
D000328:Adult; D000368:Aged; D005128:Eye Diseases / Q000175:diagnosis* / Q000209:etiology / Q000473:pathology; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009303:Nasopharyngeal Neoplasms / Q000175:diagnosis* / Q000473:pathology; D009361:Neoplasm Invasiveness; D009918:Orbital Neoplasms / Q000175:diagnosis* / Q000473:pathology