MRI增强及DWI对鼻咽癌放疗后复发的诊断价值研究

发布时间：2018-03-30 20:25

本文选题：鼻咽肿瘤　切入点：磁共振成像　出处：《磁共振成像》2016年06期

【摘要】：目的探讨磁共振平扫和增强扫描及弥散加权成像(diffusion weighted imaging,DWI)对鼻咽癌放疗后复发的诊断价值。材料与方法收集惠州市中心人民医院经病理证实为鼻咽癌并接受放射治疗的病例共380例,所有患者在放疗结束后进行6月至3年的随访复查并接受至少1次以上磁共振检查,常规进行MRI平扫和增强扫描,其中168例行DWI扫描。结果在复查过程中,共有32例证实为放疗后复发,复发的肿块形态不规则,T1WI呈等、稍低信号,T2WI呈等或稍高信号,增强后呈中等-明显强化,其中19例伴有新发颅底骨质破坏,12例伴有新增淋巴结肿大。复发肿块DWI呈高或稍高信号,其表观弥散系数(apparent diffusion coefficient,ADC)值为(0.96±0.08)×10~(-3) mm~2/s;无复发者DWI大部分呈等、稍高信号,部分呈稍低信号,其ADC值为(1.31±0.16)×10~(-3) mm~2/s,二者ADC值组间差异有统计学意义(P0.05)。结论 MRI增强和DWI成像对鼻咽癌放疗后复发诊断具有重要价值。
[Abstract]:Objective to investigate the diagnostic value of plain and enhanced MRI and diffusion-weighted imaging diffusion weighted imaging (DWI) for recurrence of nasopharyngeal carcinoma (NPC) after radiotherapy. Materials and methods collect pathologically proved nasopharyngeal carcinoma (NPC) and receive radiotherapy in Huizhou Central people's Hospital. The total number of cases treated was 380. All patients were followed up for 6 months to 3 years after radiotherapy and received at least one MRI examination. Conventional MRI plain scan and enhanced scan were performed in 168 patients. A total of 32 cases were diagnosed as recurrence after radiotherapy. The relapsed masses presented isotropic shape on T1WI, isointense or slightly hyperintense on T2WI with slightly low signal intensity, moderate and obvious enhancement after enhancement. Among them, 19 cases were accompanied with newly developed bone destruction of skull base and 12 cases with new lymphadenopathy. The DWI of recurrent masses was high or slightly high, and the apparent diffusion coefficient was 0.96 卤0.08 脳 10 ~ (-8) 脳 10 ~ (-3) mm ~ (-3) mm / s, and that of DWI without recurrence was mostly isointense, slightly hyperintense, and a little low signal intensity, and the value of ADCA was 0.96 卤0.08 脳 10 ~ (-8) 脳 10 ~ (-3) mm / s. The ADC value of the two groups was 1.31 卤0.16 脳 10 ~ (-1) mm ~ (-3) mm / s, and the difference between the two groups was statistically significant (P < 0.05). Conclusion MRI enhancement and DWI imaging are of great value in the diagnosis of recurrence of nasopharyngeal carcinoma after radiotherapy.
【作者单位】：惠州市中心人民医院放射科;
【基金】：广东省医学科学技术研究基金项目(编号:A2015536) 惠州市中心人民医院重点扶持项目(编号:2015013)~~
【分类号】：R445.2;R739.63

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