鼻咽癌放疗后磁共振灌注成像43例临床分析

Clinical research of PWI in nasopharyngeal carcinoma after radiotherapy

目的探讨鼻咽癌放疗后随访磁共振灌注成像(PWI)的临床意义。方法前瞻性分析43例放疗后鼻咽癌随诊患者均行PWI,其中经病理学证实的鼻咽癌复发患者9例,3例影像学证实颅底骨质侵犯,并观察纤维化组和复发组的Slopemax伪彩图和SI-T曲线。结果纤维化组Slopemax伪彩图显示ROI为蓝色,复发组为红色,两组Slopemax均值差异具有统计学意义(P<0.05)。结论 PWI对于鼻咽癌放疗后复发和纤维化鉴别具有一定意义,可作为鼻咽癌综合治疗后随访首选的影像学检查。

Objective To investigate the clinical significance of the perfusion weighted magnetic resonance imaging （PWI） of follow-up after radiotherapy between recurrent nasopharyngeal carcinoma （NPC） and radio-fibrosis. Methods PWI examination was applied in 43 cases with NPC diagnosed by pathology after radiotherapy,including 9 cases of recurrence proven by pathology, and 3 of skull base erosion by MRI. The pcolor of maximal increasing slope （ Slop%,x ） and signal intensity-time curve （SI-T） were observed. Results The peolors of radio-fibrosis were shown in blue of ROI, and the recurrence was shown in red. The mean of Solpe max was compared between recurrent nasopharyngeal carcinoma and radio-fibrosis, and there was statistically significant difference （ P 〈 0.05 ）. Conclusion PWI is helpful for differential diagnosis of radio-fibrosis and local recurrence after radiotherapy, which is the preferred technique of follow-up after radiotherapy in NPC.