鼻咽癌高分辨率扩散加权成像特征分析

High resolution diffusion-weighted imaging for characterising nasopharyngeal carcinoma

目的探讨鼻咽癌高分辨率扩散加权成像（DWI）分段读出序列（RESOLVE）的成像参数特征。方法回顾性分析2013年10月至2016年4月中山大学附属第五医院经病理证实的131例鼻咽癌患者，治疗前行RESOLVE-DWI检查。测量鼻咽癌DWI信号强度（SI瘸在）及表观扩散系数（ADC）值（ADC平均、ADC最大、ADC最小）；测量正常鼻咽壁DWI信号强度（SI正常）及ADC值（ADC正常）。比较鼻咽癌与正常鼻咽壁的DWI信号强度及ADC值差异，并比较不同临床分期鼻咽癌的ADC平均、ADC最女及ADC驯、差异。结果鼻咽癌SI病变明显高于正常鼻咽壁（F=70．019，P=0．000），而ADC平均、ADC最大、ADC最小明显低于正常鼻咽壁（F=20．442，P=0．000；F=35．374，P=0．000；F=61．534，P=0．000）。鼻咽癌ADC平均、ADC最大、ADC删、在不同临床总分期及T、N、M分期之间差异均无统计学意义（均P〉0．05）。结论RESOLVE-DWI可明确区分鼻咽癌组织与正常鼻咽壁，检出鼻咽癌病灶，但鼻咽癌ADC平均、ADC最大、ADC驯、尚不能用于区分鼻咽癌的临床分期。

Objective To evaluate the characteristics of high resolution diffusion-weighted imaging （DWI） using readout segmentation of long variable echo trains （ RESOLVE ） for nasopharyngeal carcinoma （NPC）. Methods A total of 131 with newly diagnosed NPC patients from the 5th Affiliated Hospital of Sun Yat-sen University were included in this study from October 2013 to April 2016. DWI using RESOLVE technique was performed. The signal intensity （ SIteaion ）, and mean （ ADCmean ）, maximum （ ADCmax ）, minimum （ADCmin ） ADCs of NPC were calculated. The signal intensity （ SInormal ） and ADC （ ADCnornal ） of normal nasopharyngeal tissue were calculated. These quantitative parameters of NPC and normal nasopharyngeal tissue were compared. Statistical difference of ADC ADCmax, and ADCmin between the clinical tumor stages were assessed. Results On the DWI, all NPCs were clearly shown as high signal intensity relative to the surrounding normal nasopharyngeal structure（F =70. 019,P =0. 000）. The ADCmean （F=20.442,P=0.000）, ADCmax（F=35.374,P=0.000）, ADCmin（F=61.534,P=0.000） in the carcinoma were significantly lower compared with that of normal nasopharyngeal structure. There was no statistically significant difference of ADC ADCm= and ADCmin （ P 〉 0. 05 ） in different clinical stages of NPC. Conclusion NPC can be clearly detected by RESOLVE-DWI, but the ADC ADCmaxand ADCmin can not be used for differentiating the clinical stage of NPC.