DWI与动态增强MRI技术在评价鼻咽癌化疗效果中的应用观察

Observation on the Application of DWI and Dynamic Enhanced MRI in Evaluating the Chemotherapy Effect of Nasopharyngeal Carcinoma

目的:探讨扩散加权成像(DWI)与动态增强磁共振成像(MRI)技术在评价鼻咽癌化疗效果中的应用情况。方法:回顾性分析本院2016年10月-2019年6月期间收治的80例鼻咽癌患者的临床病历资料和影像学资料。根据放化疗效果分为CR组和PR组,比较两组放化疗前动态增强MRI与DWI的定量参数,采用ROC曲线分析放化疗前ADC、D、K^trans预测鼻咽癌放化疗效果的价值。结果:80例鼻咽癌患者治疗总有效率为100%,其中CR为36例(45.00%)、PR为44例(55.00%)。放化疗前,CR组表观扩散系数(ADC)、真实扩散系数(D)均小于PR组,容量转移常数(K^trans)大于PR组,差异均有统计学意义(P<0.05)。ROC曲线分析结果显示联合ADC、D、K^trans预测鼻咽癌放化疗效果的曲线下面积(AUC)为0.875,高于ADC、D、K^trans单独预测的0.672、0.803、0.643(P<0.05)。结论:DWI与动态增强MRI参数ADC、D、K^trans可用于预测鼻咽癌放化疗效果。

Objective:To investigate the application of diffusion weighted imaging(DWI)and dynamic enhanced magnetic resonance imaging(MRI)in evaluating the chemotherapy effect of nasopharyngeal carcinoma.Method:The clinical and imaging data of 80 patients with nasopharyngeal carcinoma treated in our hospital from October 2016 to June 2019 were retrospectively analyzed.The patients were divided into CR group and PR group according to the effect of radiotherapy and chemotherapy.The quantitative parameters of dynamic enhanced MRI and DWI were compared between the two groups before radiotherapy and chemotherapy.The value of ADC,D,K^trans in predicting the effect of radiotherapy and chemotherapy of nasopharyngeal carcinoma before radiotherapy and chemotherapy were analyzed by ROC curve.Result:The total effective rate of 80 patients with nasopharyngeal carcinoma was 100%,including 36 patients(45.00%)with CR and 44 patients(55.00%)with PR.Before chemoradiotherapy,the apparent diffusion coefficient(ADC)and true diffusion coefficient(D)of the CR group were all lower than those of the PR group,and the volume transfer constant(K^trans)was higher than that of the PR group,the differences were statistically significant(P<0.05).ROC curve analysis results showed that the AUC of combined ADC,D and K^trans in predicting the efficacy of radiotherapy and chemotherapy for nasopharyngeal carcinoma was 0.875,higher than those of ADC,D and K^trans alone in predicting 0.672,0.803 and 0.643(P<0.05).Conclusion:DWI and dynamic enhanced MRI parameters ADC,D,K^trans can be used to predict the effect of radiotherapy and chemotherapy for nasopharyngeal carcinoma.