3.0T MR动脉自旋标记技术对T1期鼻咽癌诊断价值的初步研究

Preliminary study of 3.0T MR arterial spin labeling in the diagnosis of stage T_1 nasopharyngeal carcinoma

目的:初步探讨3.0T MR动脉自旋标记(ASL)技术对T1期鼻咽癌的诊断价值。方法:对13例经鼻咽镜活检病理证实的T1期鼻咽癌患者及14例健康志愿者行3D-ASL序列扫描,测量T1期鼻咽癌组肿瘤及健康对照组鼻咽黏膜的平均、最高及最低血流量(BF),比较两组的BF值差异,并采用受试者工作特征(ROC)曲线分析其诊断阈值及诊断效能。结果:T1期鼻咽癌组肿瘤的平均、最高及最低BF值均高于健康对照组鼻咽黏膜[分别为(81.62±47.66)和(28.25±10.41)mL/100g/min、(145.39±106.22)和(41.10±15.51)mL/100g/min、(62.92±41.13)和(19.01±6.79)mL/100g/min],差异均有统计学意义(P值均<0.05)。平均、最高及最低BF值鉴别T1期鼻咽癌组肿瘤与健康对照组鼻咽黏膜的ROC曲线下面积分别为0.934、0.951及0.918。以BF最高值>63.50mL/100g/min为阈值鉴别T1期鼻咽癌组肿瘤与健康对照组鼻咽黏膜,敏感度、特异度、阳性预测值、阴性预测值及准确率分别为92.31%、92.86%,92.31%、92.86%及92.59%。结论:3.0T MR 3D-ASL技术能够反映T1期鼻咽癌与健康对照组鼻咽黏膜的血流灌注差异,有助于鼻咽癌的早期诊断。

Objective：To investigate the value of the 3D arterial spin labeling （ASL） of MRI in the diagnosis of stage T~ nasopharyngeal carcinoma （NPC）. Methods： 13 newly diagnosed NPC patients proven by nasopharyngoscopy and 14 healthy volunteers were enrolled and underwent MR examination s,including 3D pseudo continuous ASL （pCASL） series. The mean, maximum and minimum blood flow （BF） of nasopharyngeal mucosa derived in pCASL of NPC tumor and healthy controls were measured and compared by independent sample t-test and Mann-Whitney U test. Receiver operating characteristic （ROC） curve was used to analyze the diagnostic cutoff and efficiency. Results. The mean, maximum and minimum BF of mucous membrane of stage T1 NPC were higher than those of healthy controls,which was （81. 62 ± 47. 66） mL/100g/min vs （28. 25 ± 10. 41） mL/lOOg/min, （145. 39 ± 106.22）mL/100g/min vs （41. 10±15. 51）mL/100g/min and （62. 92±41. 13）mL/100g/min vs （19.01±6.79）mL/100g/min,respectively,with significant statistic difference （P〈0. 05）. The area under the ROC curve of mean,maximum,minimum BF value was 0. 934,0. 951 and 0. 918. Setting the maximum BF value 63.50mL/100g/min as the cutoff threshold to differentiate T1 NPC and control, the sensitivity, specificity, positive predictive value, negative predictive value and accuracy was 92.31%,92.86%,92.31%,92. 86 and 92.59%, ,respectively. Conclusion-3.0T MR 3D-ASL could re flect the difference of perfusion of nasopharyngeal mucosa between stage T1 NPC and healthy controls,which is helpful for the early diagnosis of NPC.