磁共振灌注定量参数对鼻咽癌病理分化程度的鉴别价值

Value of MRI perfusion quantitative parameters in differentiating undifferentiated and differentiated nasopharyngeal carcinoma

目的:探讨磁共振灌注成像(PWI)定量参数对不同分化程度鼻咽癌(NPC)的鉴别价值。材料与方法 :对94例非角化性NPC(分化型23例、未分化型71例)行PWI。比较两组在PWI定量参数(Ktrans、Kep和Ve)上的差别。结果:未分化型NPC的Ktrans、Kep和Ve值分别为(0.378±0.161)min-1、(1.514±0.488)min-1和0.272±0.123;分化型NPC的Ktrans、Kep和Ve值分别为(0.266±0.059)min-1、(1.204±0.279)min-1和0.232±0.063。Ktrans和Kep值在两组NPC间的差异具有统计学意义(P<0.01),Ve值在两组间的差异无统计学意义。基于ROC曲线分析,对于鉴别分化型与未分化型NPC,Ktrans具有较好的敏感性(84.5%),而Kep具有较好的特异性(91.3%)。结论:分化型和未分化型NPC原发灶在PWI定量参数上存在差异,Ktrans和Kep有助于两者的鉴别。

Objective： To explore the potential value of perfusion-weighted magnetic resonance imaging（PWI） parameters in differential diagnosis between undifferentiated nasopharyngeal carcinoma（NPC） and differentiated NPC. Materials and Methods： Ninety-four patients with nonkeratinizing NPC （71 undifferentiated, 23 differentiated） underwent PWI. The difference of PWI quantitative parameters （Ktrans, Kep and Ve） was compared between the undifferentiated NPC and differentiated NPC. Results： The Ktrans, Kep and Ve values of the undifferentiated NPC were （0.378±0.161） min-1, （1.514±0.488） min-1 and 0.272±0.123, respectively. For the differentiated NPC, the Ktrans, Kep and Ve values were （0.266±0.059） min-1, （1.204±0.279） min-1 and 0.232±0.063, respectively. Both Ktrans and Kep values revealed significant difference between the undifferentiated NPC and differentiated NPC. For Ve value, no significant difference was found between the two NPC groups. Based on the receiver operating characteristic （ROC） curve, Ktrans had a sensitivity of 84.5% and Kep had a specificity of 91.3% in differentiating the two NPC groups. Conclusion： There is some difference of PWI quantitative parameters between the differentiated NPC and undifferentiated NPC. Ktrans and Kep are possibly helpful in differential diagnosis between the two NPC groups.