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中国癌症防治杂志

中国癌症防治杂志 ›› 2011, Vol. 3 ›› Issue (4): 298-302.doi: 10.3969/j.issn.1674-5671.2011.04.08

• 临床研究 • 上一篇    下一篇

磁共振扩散加权成像在鉴别鼻咽癌放疗后鼻咽坏死与复发中的价值

杨百华, 陈英, 徐鹭英, 姚逸琦, 吴君心   

  1. 福建医科大学教学医院（福建省肿瘤医院放疗科）
  • 出版日期:2011-12-25 发布日期:2012-01-20
  • 通讯作者: 吴君心 E-mail:junxinwu@126.com
  • 基金资助:

    福建省医学创新课题（2011-CX-15）

Values of diffusion-weighted imaging in differential diagnosing necrosis and recurrence of nasopharyngeal carcinoma after radiotherapy

YANG Bai-Hua, CHEN Ying, XU Lu-Ying, YAO Yi-Qi, WU Jun-Xin   

  • Online:2011-12-25 Published:2012-01-20

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被引次数

28

摘要： 目的 评价磁共振扩散加权成像(DWI)以及表观扩散系数(ADC)值测量在鼻咽癌放疗后鼻咽坏死与复发鉴别诊断中的应用价值。方法 2008年7月至2010年12月，35例经我院治疗并经病理诊断证实的鼻咽癌放疗后鼻咽坏死和同期随机选取的35例鼻咽癌放疗后复发的患者，均接受了常规MRI检查及DWI(扩散敏感系数，即b值采用：0s/mm2及 800s/mm2),分别测量放疗后鼻咽坏死灶及肿瘤复发区的ADC值，计算其平均值。结果 鼻咽坏死灶在DWI上表现为不均匀的低信号，而肿瘤复发病灶表现为高信号。鼻咽坏死组及复发组ADC平均值分别为（1.073±0.0383）×10.3mm2/s和（0.844±0.0309）×10.3mm2/s；最大值分别为（1.728±0.0527）×10.3mm2/s和（1.477±0.0675）×10.3mm2/s。鼻咽坏死组ADC平均值及最大值均大于复发组，差异有统计学意义(t1=4.645，P＜0.001；t2=2.932，P＜0.005)。结论 DWI以及ADC值测量在鼻咽癌放疗后鼻咽坏死与复发的鉴别诊断中具有重要价值,可作为常规MR序列的重要补充。

关键词: 鼻咽癌 , 坏死, 复发, DWI, ADC

Abstract: Objective To evaluate the role of diffusion-weighted imaging (DWI) and the value of apparent diffusion coefficient (ADC) in differential diagnosing necrosis and  recurrence of nasopharyngeal carcinoma after radiotherapy.Methods From Jul 2008 to Dec 2010，thirty-five patients were diagnosed postradiation nasopharyngeal necrosis，which were matched with the same number of patients randomly selected from the same period. All patients were confirmed pathologically，and received routine MRI and DWI (with the b values of 0s/mm2 and 800s/mm2). ADC values of necrotic foci and parts of recurrence tumor were measured，and their mean ADC values were calculated.Results  Nasopharyngeal necrosis usually showed heterogeneity and low signal on DWI，but the recurrence group showed high signal.The mean ADC values in nasopharyngeal necrosis group and recurrence group were (1.073±0.0383)×10.3mm2/s and (0.844±0.0309)×10.3mm2/s respectively，the difference of which was statistically significant (t=4.645，P＜0.001). The maximal values in these two groups were (1.728±0.0527)×10.3mm2/s and (1.477±0.0675)×10.3mm2/s respectively，the difference of which was also statistically significant (t=2.932，P＜0.005). Conclusions DWI and ADC value are important in differential diagnosis of nasopharyngeal necrosis and tumor recurrence after radiotherapy.DWI and ADC can be used as important supplementary to routine MRI.

Key words: Nasopharyngeal carcinoma, Necrosis, Recurrence, DWI, ADC