MRI在鼻咽癌放疗患者疗效评估中的应用

Application of MRI in Evaluating the Efficacy of Radiotherapy for Patients with Nasopharyngeal Carcinoma

目的探讨磁共振成像(MRI)在鼻咽癌放疗患者疗效评估中的应用。方法选取2014年3月至2019年3月就诊于我院的88例疑似鼻咽癌患者,均行MRI检查。以病理活检结果为金标准,计算MRI检查的准确度、特异度、灵敏度,并比较放疗前后的原发病灶及转移淋巴结的表观扩散系数(ADC)值和肿瘤面积。结果 88例疑似鼻咽癌患者中,病理活检确诊71例;以病理活检结果为金标准,MRI诊断的准确度为80.68%,灵敏度为87.32%,特异度为52.94%。放疗后,原发病灶及颈部转移淋巴结节的ADC值均显著高于放疗前,肿瘤面积显著小于放疗前,差异有统计学意义(P<0.05)。结论 MRI诊断鼻咽癌的准确度、灵敏度较高,MRI扩散加权成像技术可有效用于鼻咽癌放疗效果的评估中,快速显示放疗前后的肿瘤变化。

Objective To explore the application of magnetic resonance imaging(MRI) in the evaluation of the efficacy of radiotherapy for patients with nasopharyngeal carcinoma. Methods Eighty-eight patients with suspected nasopharyngeal carcinoma admitted to our hospital from March 2014 to March 2019 were enrolled. All patients underwent MRI. With pathological biopsy results as the gold standard, the accuracy, specificity and sensitivity of MRI examination were calculated. The ADC value of primary lesions and metastatic lymph nodes, and the tumor area before and after radiotherapy were compared. Results Of the 88 patients with suspected nasopharyngeal carcinoma, 71 were diagnosed by pathological biopsy. With pathological biopsy results as the gold standard, the accuracy,sensitivity and specificity of MRI diagnosis was 80.68%, 87.32% and 52.94% respectively. After radiotherapy, the ADC values of primary lesions and cervical metastatic lymph node were significantly higher than those before radiotherapy, and the tumor area was significantly smaller than that before radiotherapy, with statistically significant differences(P<0.05).Conclusions MRI has high accuracy and sensitivity in the diagnosis of nasopharyngeal carcinoma. Diffusion weighted MRI technology can be used to evaluate the radiotherapy effect for nasopharyngeal carcinoma, and can quickly display the tumor changes before and after radiotherapy.