鼻咽癌转移性淋巴结化放疗疗效应用DWI监测价值分析

Nasopharyngeal Carcinoma Metastatic Lymph Node Radiotherapy Application DWI Monitor the Efficacy of Value Analysis

目的临床应用弥散加权成像(DWI)于鼻咽癌转移性淋巴结化放疗中,并通过监测治疗过程中表观弥散系数(ADC)变化情况来评价DWI对患者化放疗的应用价值。方法选取本院经手术及病理证实的60例鼻咽癌患者进行研究,并采用化放疗治疗。分别于首次化疗前1天、第二次化疗前1天、首次放疗前1天、第15天放疗当日和第30次放疗当日及治疗结束1个月后采用MRI及DWI进行检查。结果 (1)治疗前,淋巴结平均ADC值为(0.792±0.019)×10-3mm2/s明显低于正常舌肌ADC值(1.387±0.035)×10-3mm2/s,P<0.05;(2)随着治疗的进行,患者转移性淋巴结ADC值随之而不断上升,但第1-15次放疗期间上升最为显著;(3)经治疗后,患者残留淋巴结ADC值平均为(1.399±0.079)×10-3mm2/s较治疗前明显增高,P<0.05;但其与治疗后正常舌肌ADC值比较,P>0.05。结论通过采用DWI及MRI监测鼻咽癌转移性淋巴结患者化放疗治疗过程中ADC值变化,可有效评估临床疗效,从而为患者临床合理化治疗提供参考。

Objective Clinical application of diffusion-weighted imaging （DWI） in nasopharyngeal carcinoma metastatic lymph node radiotherapy in the treatment process and by monitoring the apparent diffusion coefficient （ADC） to evaluate changes in the value of radiotherapy in patients with DWI.Methods Select the hospital after surgery and pathology confirmed 60 cases of nasopharyngeal carcinoma patients were studied, and the use of radiotherapy. Respectively, one day before the first chemotherapy, the second one days before chemotherapy, one day before the first radiotherapy, radiotherapy day and the 15th day of the 30th day of radiotherapy and one month after the end of treatment using MRI and DWI checks.Results （1） Before treatment, the mean ADC value of lymph node （0.792±0.019）×10-3mm2/s ADC values were significantly lower than normal tongue （1.387±0.035）×10-3mm2/s, P 〈0.05; （2） with the treatment progresses, patients with metastatic lymph nodes attendant rising ADC value, but during the first 1 to 15 times the most significant increase in radiation; （3） after treatment, the residual lymph nodes in patients with average ADC value （1.399±0.079）×10-3mm2/s was significantly higher than before treatment, P〈0.05; but after treatment compared with normal tongue ADC value, P〉0.05.Conclusion Through the use of DWI and MRI monitoring of metastatic lymph nodes in patients with nasopharyngeal carcinoma radiotherapy ADC value change during treatment, which can effectively evaluate the clinical efficacy, which provides a reference for the clinical treatment of patients rationalization.