酰胺质子转移MRI在鼻咽肿瘤诊断中的初步应用

Preliminary application of amide proton transfer-MRI in diagnosis of nasopharyngeal carcinomas

目的探讨酰胺质子转移(amide proton transfer,APT)成像在鼻咽部组织中的应用价值。材料与方法回顾性研究2020年6月至2021年2月经病理证实的50例鼻咽癌患者的磁共振APT图像以及临床、病理资料。由2名放射医师独立分析APT图像对病灶的显示效果,二者的评价结果使用Kendall’s Tau-b分析其一致性。通过配对样本t检验分析左右侧颞肌、腮腺、小脑和鼻甲在APT值上的一致性以及同层鼻咽癌组织和正常鼻咽组织以及左右侧颞肌、腮腺、小脑、鼻甲APT值的差异,使用独立样本t检验分析分化型和未分化型两种类型鼻咽癌APT值的差异。结果关于APT图像对病灶的显示效果分析,2名放射诊断医生的评价一致性为0.844。左右侧颞肌、腮腺、小脑和鼻甲的APT值差异没有统计学意义,P值分别为0.475、0.765、0.443和0.544。鼻咽癌病灶与正常鼻咽和腮腺组织的APT值差异不具有统计学意义(P=0.338与P=0.664、0.933),但鼻咽癌病灶的APT值明显高于左右侧颞肌和小脑组织(P<0.001),但低于鼻甲组织(P<0.001)。分化型鼻咽癌的APT值为1.97%±0.89%,未分化型鼻咽癌的APT值为1.95%±0.82%,二者的差异无统计学意义(P=0.944)。结论研究结果表明APT成像对于鼻咽部的病灶显示效果满意,并证实了该成像方式在鼻咽部具有技术可行性,能够对于该区域不同组织类型的APT效应进行精确定量,为APT成像应用于鼻咽部提供了一定的实践经验。

Objective:To explore the potential value of applying amide proton transfer weighted imaging(APT-weighted imaging)in nasopharynx.Materials and Methods:From June 2020 to February 2021,50 patients with pathologically confirmed nasopharyngeal carcinoma(NPC)who have undergone APT-weighted imaging were retrospective enrolled,and their APT-weighted imaging and clinicopathological data were collected.Two radiologists independently evaluated the performance of APT map in depicting the NPC lesion and their consistency was tested using Kendall’s Tau-b was used to analyze the consistency of the results by the two radiologists.Paired t-test was used to analyze the consistency in the APT values between the left and right side of temporal muscles,parotid glands,cerebellum and turbinate and the difference in the APT values between nasopharyngeal carcinoma tissue and normal nasopharyngeal left and right temporal muscle,parotid glands,cerebellum and turbinate on the same slice.Student t-test was used to compare APT values between differentiated and undifferentiated subtypes of NPC.Results:In terms of performance of lesion depiction,two radiologists agreed with a correlation coefficient of 0.844.There were no significantly difference in APT values between left and right of temporal muscles,parotid glands,cerebellum,and turbinates(P=0.475,0.765,0.443,and 0.544,respectively).The difference in APT values between nasopharyngeal carcinoma lesions and normal nasopharyngeal and parotid gland tissues was not statistically significant(P=0.338 vs.P=0.664&0.933),but the APT values of nasopharyngeal carcinoma lesions were significantly higher than the left and right temporal muscles and cerebellum tissues(P<0.001),but lower than the turbinate tissue(P<0.001).When it comes to subtypes of NPC,no significant difference was found in APT values between differentiated 1.97%±0.89% and undifferentiated NPC 1.95%±0.82%.Conclusions:This study showed that APT imaging is satisfactory in depicting nasopharyngeal lesions,and technically feasible in the nasopharyngeal area.APT effect of different tissue types can be accurately quantified in this area,which provides practical experience in clinically applying APT imaging to the nasopharynx.