鼻咽癌放疗后局部复发和纤维变的螺旋CT动态增强研究

The dynamic enhanced characteristics of the recurrentnasopharyngeal carcinoma and the radiofibrosis in spiral CT

目的：探讨鼻咽癌放疗后局部复发和纤维变的螺旋ＣＴ动态增强特征。材料与方法：放疗后纤维变组（ＲＦ组）５０例，放疗后复发组（ＲＮＰＣ组）４６例，先平扫，然后选择“兴趣区”行同层动态增强扫描。采用ＥＬＳＣＩＮＴＣＴ－ＦＬＡＳＨ双螺旋ＣＴ扫描机，自动压力注射器注药。分别测量平扫与增强后不同时刻的ＣＴ值，进行统计学处理并描绘密度－时间曲线。结果：１．ＲＦ组于增强后２１０秒时达峰值，其动态增强曲线形态特征呈一“缓升－缓降”型。２．ＲＮＰＣ组于增强后１５０秒时达峰值，其动态增强曲线特征呈一“速升－缓升－缓降”型。３．注射造影剂后４０秒至３００秒期间，ＲＦ组与ＲＮＰＣ组间各对应时刻点ＣＴ值均数均有显著性差异（Ｐ＜０．００１）。ＲＮＰＣ组明显高于ＲＦ组。结论：ＲＦ与ＲＮＰＣ的螺旋ＣＴ动态增强曲线特征及病变区ＣＴ值的明显差异可作为两者鉴别诊断的重要依据。

Objectives: To discuss the characteristics of the dynamic enhanced Density-Time curves of recurrent nasopharyngeal carcinoma(RNPC)and the radiofibrosis (RF) in the spiral CT. Materials and methods: 50 cases of RF and 46 cases of RNPC were examined in spiral CT. The CT numbers of the regions of interest (ROI) at various acquisitions of time (0s,20s,30s,40s,50s,60s,90s,120s,150s,180s,210s,240s,270s and 300s after the beginning of the contrast injection) were collected. The CT value differences of various acquisitions of time were analysed statisticaly and the dynamic enhanced density-time curves were established. Results: 1.The typical curve of the RF group is a slowly ascending-slowly descending one. Its peak CT values were seen at 210ses postcontrastly and measured 60.1±2.57. 2. The typical curve of the RNPC is one of rapidly ascending-slowly ascending-slowly descending. Its peak CT numbers were seen at 150sec postcontrastly and measured 75.4±7.2Hu. 3.The differences of CT numbers are obviously between the RNPC and RF from 40s to 300s postcontrastly. Conclusions: The characteristics of the dynamic enhanced density-time curves of RF and RNPC may be as the important informations for differential diagnosis.