体素内不相干运动扩散加权成像评估淋巴结转移对头颈部鳞癌治疗应答率的预测价值

发布时间：2018-09-02 05:38

【摘要】：目的体素内不相干运动扩散加权成像(IVIM-DWI)评估头颈部鳞状细胞癌(HNSCC)淋巴结转移弥散和微灌注情况。采用IVIM参数进行淋巴结分期,并根据随访获得的治疗应答率数据分析IVIM参数的预测价值。方法 15例经病理确诊的局部晚期头颈部鳞癌淋巴结转移患者在施行非手术保留器官治疗前进行弥散加权成像(DWI)检查。使用8种不同的b值(0~800 s/mm2)进行3 T DWI成像。IVIM双指数拟合计算灌注指数f和扩散系数D。所有患者随访期均为13.5个月。对所有患者进行感兴趣区(ROI)分析。结果 13.5个月随访期间,15例患者中3例局部复发(LRF)。LRF患者初始f值高于局部区域控制(LRC)患者(14.5±0.6)%vs(7.7±2.6)%(P=0.001)。两组间初始扩散系数D差异无统计学意义(0.97±0.15)×10-3 mm2/s vs(0.88±0.13)×10-3 mm2/s(P=0.301)。结论淋巴结中初始灌注指数f具有预测HNSCC患者局部复发率和治疗应答率价值。
[Abstract]:Objective To evaluate the diffusion and microperfusion of lymph nodes in head and neck squamous cell carcinoma (HNSCC) by intravoxel incoherent diffusion-weighted imaging (IVIM-DWI). The IVIM parameters were used for lymph node staging, and the predictive value of IVIM parameters was analyzed according to the treatment response rate obtained during follow-up. Methods 15 patients with locally advanced head and neck carcinoma (HNSCC) were diagnosed by pathology. Diffusion-weighted imaging (DWI) was performed in patients with lymph node metastasis of squamous cell carcinoma before non-surgical organ-sparing therapy. Three T-DWI images were performed with eight different b values (0-800s/mm2). The perfusion index F and diffusion coefficient D were calculated by the bi-exponential fitting of IVIM. All patients were followed up for 13.5 months. Results During the follow-up period of 13.5 months, 3 of the 15 patients had local recurrence (LRF). The initial F value of LRF patients was higher than that of LRC patients (14.5+0.6)% vs (7.7+2.6)% (P=0.001). There was no significant difference in the initial diffusion coefficient D between the two groups (0.97+0.15)*10-3 mm2/s vs (0.88+0.13)*10-3 mm2/s (P=0.301). The index F has the value of predicting the local recurrence rate and response rate of HNSCC patients.
【作者单位】：南华大学附属第二医院医学影像科;
【分类号】：R445.2;R739.91

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