MR灌注成像对喉癌和下咽癌术后放疗后并发症及肿瘤复发的诊断价值

The diagnostic value of MR perfusion weighted imaging on complications and tumor recurrence in hypopharyngeal and laryngeal cancer after operation and radiotherapy

目的：探讨MR灌注加权成像（PWI）对喉癌和下咽癌术后放疗后并发症及肿瘤复发的诊断价值。方法对31例喉癌及下咽癌术后放疗后,喉镜及手术证实为肿瘤复发、肉芽组织增生及局部感染患者行MR PWI检查，测量病变组织血流量（BF）、血容量（BV）、平均通过时间（ MTT）及达峰时间（TTP）。所测数据统计分析采用单因素方差分析及两两比较q检验。结果肿瘤复发组11例、肉芽组织增生组11例、感染组9例。 BF、BV、MTT及TTP在复发肿瘤患者分别为（145.1±29.3）ml ·100 g-1· min-1、（14.2±3.2）ml ·100 g-1、（5.4±0.6）s、（13.7±1.3）s；在肉芽组织分别为（109.1±27.4）ml ·100 g-1· min-1、（11.1±1.7）ml ·100 g-1、（7.7±1.0）s、（19.8±2.1）s；在感染组织分别为（86.9±7.7）ml ·100 g-1·min-1、（8.8±1.0）ml·100 g-1、（8.0±0.9）s、（19.7±1.3）s。复发肿瘤组BF、BV大于肉芽组织增生组（q值分别为4.89、4.64，P〈0.01）及感染组（q值分别为7.52、7.71，P〈0.01）；肉芽组织增生组BV大于感染组（q=3.31，P〈0.05）；肿瘤复发组MTT、TTP小于肉芽组织增生组（q值分别为9.38、12.48，P〈0.01）及感染组（q值分别为9.77、11.53，P〈0.05）；肉芽组织增生组与感染组BF、MTT、TTP差异无统计学意义。结论通过MR PWI可提高喉癌和下咽癌术后放疗后并发症及肿瘤复发的鉴别诊断。

Objective To explore diagnostic value of MR perfusion weighted imaging（PWI）on complications and tumor recurrence in hypopharyngeal and laryngeal cancer after operation and radiotherapy. Methods MR PWI was performed in 31 patients with hypopharyngeal and laryngeal cancer who suffer from tumor recurrence, granulation or infection after operation and radiotherapy. Blood flow （BF）, blood volume（BV）, mean transit time（MTT） and time to peak （TTP） values were measured in the lesions. Analysis of variance and pair-wise comparison of q test were used for statistical analysis. Results Eleven cases with tumor recurrence,11 case with granulation tissues, 9 cases with infection were confirmed by pathological examinations. Average BF, BV, MTT and TTP values of recurrent tumors were （145.1 ± 29.3）ml · 100 g-1 · min-1,（14.2 ± 3.2）ml · 100 g-1,（5.4 ± 0.6）s,（13.7 ± 1.3）s respectively;Average BF, BV MTT and TTP values of granulation tissues were（109.1±27.4）ml·100 g-1·min-1,（11.1±1.7）ml·100 g-1,（7.7±1.0）s, （19.8 ± 2.1）s respectively;Average BF, BV, MTT and TTP values of infectious tissues were（86.9 ± 7.7）ml · 100 g-1·min-1,（8.8±1.0）ml·100 g-1,（8.0±0.9）s,（19.7±1.3）s respectively. Average BF and BV values of the recurrent tumors group were higher than those of the granulation（q=4.89, 4.64 respectively,P〈0.01）and infection group（q=7.52,7.71 respectively,P〈0.01）respectively. Average BV values of granulation group was higher than that of the infection group（q=3.31,P〈0.05）, Average MTT and TTP values of recurrent tumor group were lower than those of the granulation （q=9.38, 12.48 respectively,P〈0.01）and infection group（q=9.77, 11.53 respectively,P〈0.05）. There were no significant difference in average BF, MTT and TTP between the granulation and infection group. Conclusion MR PWI can be helpful in the diagnosis of complications and tumor recurrence in hypopharyngeal and laryngeal cancer after operation and＆amp;nbsp;radiotherapy.