咽后淋巴结的体素内不相干运动在鼻咽癌分期中的应用

Retropharyngeal Lymph Node Intravoxel Incoherent Motion in the Staging of Nasopharyngeal Carcinoma

目的探讨基于体素内不相干运动技术在鼻咽癌分期的应用可行性,进一步探讨咽后淋巴结的D、D*、f、ADC在分期中的价值。方法收集2014年1月—2015年1月我院鼻咽癌初诊患者106例,男79例,女27例,年龄22~69岁,中位年龄42岁。所有患者均行3T MR扫描,IVIM采用8个b值(0、50、100、150、200、250、700、800)s/mm^2。根据不同TNM分期分成两组,A组为低分期组(T_(low)、N_(low)、Low),B组为高分期组(T_(high)、N_(high)、High)。结果与T_(high)的D(0.6887±0.081 3)×10^(-3)mm^2/s、f(10.27±4.51)和ADC(0.7972±0.086 3)×10^(-3)mm^2/s比较,T_(low)的D(0.762 7±0.086 8)×10^(-3) mm^2/s、f(13.66±5.61)和ADC(0.922 9±0.104 7)×10^(-3) mm^2/s增高,差异有统计学意义(P<0.001、0.002、<0.001);与High的f(10.72±4.84)和ADC(0.820 0±0.099 9)×10^(-3)mm^2/s比较,Low的f(16.19±4.49)和ADC(0.941 6±0.123 7)×10^(-3)mm^2/s增高,差异有统计学意义(P=0.003、0.002)。结论 IVIM技术在鼻咽癌的应用可行,咽后淋巴结的D、f、ADC在鉴定鼻咽癌的分期具有潜在的价值。

Objective To study intravoxel incoherent motion technology based on the feasibility of the application in nasopharyngeal carcinomastaging, to further explore the retropharyngeal lymph node of D, D＊, f, ADC in the staging. Methods A total of 106 patients with nasopharyngeal carcinoma diagnosed in our hospital from January 2014 to January 2015 were enrolled, including 79 males and 27 females, aged 22 to 69 years old, and menian age was 42 years old. All patients underwent 3T and MR scans, and IVIM was performed with 8 b values（0, 50, 100, 150, 200, 250, 700, 800） s/mm^2. The patients were divided into two groups according to different TNM stages. The A group was the low stage group（T_（low）, N_（low）, Low）, and the B group was the high stage group（T_（high）, N_（high）, High）. Results Compared with T_（high） of D（0.688 7±0.081 3） ×10^（-3）mm^2/s, f（10.27±4.51） and ADC（0.797 2± 0.086 3） ×10^（-3）mm^2/s, T_（low） of D（0.762 7±0.086 8）×10^（-3）mm^2/s, f（13.66±5.61） and ADC（0.922 9±0.104 7）×10^（-3）mm^2/s increased, the difference was statistically significant（P〈0.001, 0.002, 0.001）; Compared with the High of f（10.72±4.84） and ADC（0.820 0±0.099 9） × 10^（-3）mm^2/s, the Low of f（16.19±4.49） and ADC（0.941 6±0.123 7） × 10^（-3）mm^2/s increased, the difference was statistically significant（P=0.003, 0.002）. Conclusion The application of IVIM technology in nasopharyngeal carcinoma is feasible, retropharyngeal lymph node of D, f and ADC in the identification of nasopharyngeal carcinoma staging has potential value.