鼻咽癌放疗后局部纤维化与肿瘤复发的MRI灌注成像研究

发布时间：2018-07-08 19:32

本文选题：鼻咽肿瘤 + 磁共振成像　；参考：《影像诊断与介入放射学》2016年03期

【摘要】：目的探讨MRI灌注成像对鼻咽癌放疗后局部纤维化与肿瘤复发的诊断价值。方法将放射治疗后鼻咽癌局部纤维化(31例)及肿瘤复发病例(25例)共56例分为2组,采用FLASH序列进行动态增强及灌注成像扫描,获得动态增强时间-信号强度曲线类型,统计分析动态增强及灌注成像参数:达峰时间(TTP)、最大斜率(Slope_(max))、曲线下面积(AUC),并获取伪彩图,及进行统计学处理。结果放疗后复发组动态增强时间-信号曲线类型均呈速升型,出现明显上升期,随后转为平台期或缓升缓降期;放疗后纤维化组时间-信号曲线呈缓升型,出现缓慢上升期,随后转为平台期或缓升缓降期。2组病例MRI动态增强参数TTP、Slope_(max)、AUC的均值行组间两两比较,复发组和纤维化组的Slope_(max)、TTP均值存在统计学差异,t值分别为67.18、-21.04(P0.05)。灌注参数伪彩图可直观的显示肿瘤或放疗后纤维化组织相应的血流灌注情况,发现AUC灌注伪彩图显示肿瘤组织较为清晰,分辨率较好。结论应用MR动态增强及灌注成像有助于鉴别鼻咽癌复发和纤维化。
[Abstract]:Objective to evaluate the value of MRI perfusion imaging in diagnosis of local fibrosis and tumor recurrence after radiotherapy in nasopharyngeal carcinoma (NPC). Methods Fifty-six patients with local fibrosis (31 cases) and recurrent cases (25 cases) of nasopharyngeal carcinoma after radiotherapy were divided into two groups. Dynamic contrast enhancement and perfusion imaging were performed with flash sequence to obtain the type of dynamic enhancement time-signal intensity curve. The parameters of dynamic enhancement and perfusion imaging: peak time (TTP), area under Slope _ (max), curve (AUC) were analyzed, and pseudo-color images were obtained and processed statistically. Results the type of dynamic enhancement time-signal curves in patients with recurrence after radiotherapy was rapid ascending, and then changed to platform stage or slowly rising and descending phase, and the time-signal curve of fibrosis group showed slow rising type and slow rising period after radiotherapy. The mean value of TTPN Slope _ (max) was compared between the two groups. There was statistical difference between the recurrent group and the fibrosis group. The difference was 67.18 ~ 21.04 (P0.05). Perfusion parameters pseudochromogram can directly display the blood perfusion of tumor or fibrosis tissue after radiotherapy. It is found that the perfusion pseudochromogram of AUC shows tumor tissue clearly and has good resolution. Conclusion dynamic contrast-enhanced Mr and perfusion imaging are helpful in differentiating recurrence and fibrosis of nasopharyngeal carcinoma.
【作者单位】：深圳市人民医院(暨南大学第二临床医学院)放射科;
【基金】：2010年深圳市科技计划项目(201002008) 深圳市重点学科基金资助(297182)
【分类号】：R445.2;R739.63

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