CT灌注成像在反映鼻咽癌放疗效果及预后评估中的可行性分析

Feasibility of CT Perfusion Imaging in Evaluating the Radiotherapy Effect and Prognosis of Nasopharyngeal Carcinoma

目的分析CT灌注成像在反映鼻咽癌放疗效果及预后评估中的可行性。方法回顾性分析2017年1月至2018年3月在本院收治的50例为鼻咽癌患者。所有患者都进行MSCT检查。对所有患者一年后进行随访以及MSCT检查,对患者所得图像进行分析,比较治疗前和放疗中鼻咽癌患者的灌注值,以及随访后复发转移者和无肿瘤生存者的灌注值。结果50例鼻咽癌患者在放疗前与放疗中BF、BV、PS、MTT值比较差异无统计学意义(P>0.05);PH值放疗中明显低于治疗前(P<0.05)。50例患者中有效随访36例,其中有复发转移者13例,无肿瘤生存者23例。13例复发/转移者与23例无肿瘤生存者的BF、BV、PS、MTT、PH值,两者比较差异无统计意义(P>0.05)。结论CT灌注成像参数变化可反映出鼻咽癌患者肿瘤内微循环特征,在放疗后强化分值有明显减低,但在预后评估中仍缺乏特异性。

Objective To study the feasibility of CT perfusion imaging in evaluating the radiotherapy effect and prognosis of nasopharyngeal carcinoma.Methods 50 patients treated in our hospital from January 2017 to March 2018 with nasopharyngeal carcinoma were retrospectively analyzed.All patients underwent MSCT examination.All patients were followed up one year later,and MSCT was performed.The images of the patients were analyzed to compare the perfusion values of patients with nasopharyngeal carcinoma before and during radiotherapy.After the follow-up,the perfusion values of patients with recurrent metastasis and the survivals without tumors were compared.Results There were no significant differences in bF,bV,PS,and MTT between 50 patients with nasopharyngeal carcinoma before and after radiotherapy(P>0.05).The PH value in radiotherapy was significantly lower than that before treatment(P<0.05).In the 50 patients,36 were followed up effectively,including 13 patients with recurrent metastasis and 23 survivals without tumor.There were no statistically significant differences in bF,bV,PS,MTT,and PH between patients with recurrent metastasis and 23 survivals without tumor(P>0.05).Conclusion The changes in parameters of CT perfusion imaging can reflect the characteristics of intratumoral microcirculation in patients with nasopharyngeal carcinoma.After radiotherapy,the enhancement score was significantly reduced,which still lacks specificity in evaluating prognosis.