磁共振弥散成像(DWI)对鼻咽癌颅底骨侵犯的诊断评价

The Value of Dwi in Detecting Skull Base Invasion in Nasopharyngeal Carcinoma

目的探讨磁共振弥散成像(DWI)在鼻咽癌颅底骨侵犯中的诊断价值,尤其是在鼻咽癌早期骨浸润中的作用。方法应用DWI技术及磁共振常规扫描技术对病理确诊为鼻咽癌的患者进行扫描,应用上述技术,对2008年1月～2009年2月间在福建省肿瘤医院的350例临床诊断为鼻咽癌的初诊病人进行分组和观察。所有病例行常规MRI平扫+增强及横轴位DWI扫描并进行对比分析。结果诊断颅底侵犯196例,常规序列显示颅底信号异常207例,假阳性11例,符合率为94.7%,弥散成像(DWI)信号异常196例,符合率达100%,结论磁共振弥散成像(DWI)在鼻咽癌颅底侵犯的诊断中比常规MRI扫描准确率更高,具有重要的应用价值,尤其便是在MRI常规扫描及其它影像学技术无法确认是否有颅底侵犯时能提供必要的帮助,同时对治疗方案的制定与调整及评价疗效均有重要意义。

Objective To explore the value of DWI in detecting skull base invasion in nasopharyngeal carcinoma（NPC）, especially early invasion of skull base. Method From january 2008 to february 2009,350 patients with pathologically confirmed NPC were received conventional MR and DWI scan. the results of DWI were compared witb conven- tional MR. Result A total of 196 NPC patients with skull base invasion were found using DWI, the accuracy was 100%（196/196）. Conventional MR showed abnormal signal of skull base in 207 NPC patients, the accuracy was 94.6%（196/207）. Conclusion DWI has important value in the detecting of skull base invasion in nasopharyngeal carcinoma, especially for other imaging techniques could＇t distinguish skull base invasion.DWIis useful in making therapeutic decisions and in evaluating effects of the therapy.