磁共振弥散成像在鼻咽癌复发诊断中的临床意义

The Value of the Diffusion-weighted MRI Imaging in the Diagnosis of Relapse of Nasopharyngeal Carcinoma

目的探讨磁共振弥散加权扫描在诊断鼻咽癌复发中的意义。方法 43例经病理检查确诊的鼻咽癌复发患者,分别行磁共振常规及弥散扫描,对比常规磁共振扫描和弥散扫描肿瘤范围,并通过配对t检验比较肿瘤区与正常组织(一般取对侧正常组织或肿瘤组织旁正常组织,避开骨质和血管)弥散系数值(ADC值)差异。结果常规磁共振扫描显示病灶的DWI像同样呈相对高信号,两者病灶范围基本吻合。鼻咽复发病灶ADC值高于正常鼻咽黏膜ADC值(P<0.0001)。43例患者中31例肿瘤超腔(侵犯咽旁、副鼻窦及颅底等),鼻咽腔外复发病灶ADC值高于相应正常组织ADC值(P<0.0001)。结论磁共振弥散扫描有助于判断鼻咽癌是否复发,尤其对无法取得病理诊断的复发鼻咽癌具有重要的助诊意义。

Objective To explore the value of apparent diffusion coefficient（ADC） values in the diagnosis of relapse of nasopharyngeal carcinoma.Methods 43 patients with histologically proved locoregional relapse nasopharyngeal carcinoma,who were treated by radiotherapy previously,underwent routine and diffusion-weighted MRI imaging respectively.A compare of relapse gross tumor volumes in both imaging was performed on each patient.The ADC values of the tumor and peripherally parallel regions,eluding bone and blood vessel,were calculated and analyzed.Both ADC values of each patient were analyzed by paired-samples test.Results Relapse gross tumor volumes in routine MRI imaging also process presented hyperintensity in diffusion-weighted MRI imaging.The ADC values of the local relapse gross tumor volumes are higher than those of nasopharyngeal nasopharyngeal epithelium（P〈0.0001）.For 31 patients whose tumor out of nasopharyngeal,the ADC values of the tumor volumes outside the nasopharyngeal are higher than those of parallel regions（P〈0.0001）.Conclusion The diffusion-weighted MRI imaging is helpful in differentiation of relapse nasopharyngeal carcinoma,especially for patients who can not get histological diagnosis.