MRI增强扫描在判定鼻咽癌根治性放疗前后疗效中的应用价值

Application value of MRI enhanced scanning in judging the efficacy of nasopharyngeal carcinoma before and after radical radiotherapy

目的:探讨核磁共振成像术(MRI)增强扫描在判定鼻咽癌(NPC)根治性放疗前后疗效中的应用价值。方法:选取2013年9月~2016年5月在我院行根治性放疗NPC患者54例,均于根治性放疗前后行鼻咽、颅底、颈部常规MRI平扫及增强扫描。观察放疗前后肿瘤病灶范围、形态及对周围组织侵犯情况变化。结果:放疗后经MRI增强扫描复查,49例NPC患者原发灶范围不同程度缩小,提示根治性放疗总有效率达90.74%,此外,影像结果显示肿瘤病灶边界较之前变清,侵犯范围有所缩小,伴颈部淋巴结肿大者其淋巴结直径均有所减小;剩余3例较放疗前无明显变化,2例肿瘤范围增大,颈部淋巴结退缩不明显甚至增大,并向颅底侵犯。结论:MRI增强扫描可对鼻咽癌根治性放疗前后疗效作出有效判定,进而有利于为治疗方案的调整提供重要依据。

Objective To evaluate the value of magnetic resonance imaging（ MRI） in determining the therapeutic efficacy of nasopharyngeal carcinoma（ NPC） before and after radical radiotherapy Methods 54 patients with NPC in our hospital from September 2013 to May 2016 were selected. All patients underwent conventional MRI and enhanced MRI before and after radical radiotherapy for nasopharyngeal,skull base and neck. The changes of tumor size,shape and invasion of surrounding tissues were observed before and after radiotherapy. Results After radiotherapy,the primary focus of 49 cases of NPC patients was narrowed in different degree suggesting that the total effective rate of radical radiotherapy 90. 74%. In addition,the imaging results showed that the tumor lesion boundary became clearer than before,the extent of invasion narrowed,with lymph node enlargement of cervical lymph nodes were reduced; the remaining 3 cases had no significant change before radiotherapy,2 cases of tumor size increased. Neck lymph node withdrawal was not obvious or even increased with invasion of the skull base. Conclusion MRI enhanced scanning can effectively determine the efficacy before and after radiotherapy in patients with nasopharyngeal carcinoma. And then it is beneficial to provide an important basis for the adjustment of the treatment plan.