3.0T磁共振读出方向上的分段扩散成像技术对老年鼻咽癌放化疗疗效的评价

Analysis of the segmental diffusion imaging in the readout direction of 3.0T magnetic resonance in the evaluation of the curative effect of radiotherapy and chemotherapy in elderly patients with nasopharyngeal carcinoma

目的分析3.0T磁共振读出方向上的分段扩散成像技术对鼻咽癌放化疗疗效的临床应用价值。方法选取2013年8月-2018年6月海军军医大学附属长海医院收治的鼻咽癌患者300例,所有患者治疗前的ADC值(表观扩散系数)、ROI(感兴趣区)面积基本一致,差异无统计学意义(P>0.05)。患者随机分为对照组和观察组,每组150例,对其放化疗治疗后做磁共振检查。对照组患者采用EPI-DWI(常规平面回波成像-扩散加权成像)的方式进行检测,观察组采用RESOLVE(读出方向上的分段扩散成像技术)的方式进行检测。调查并对比分析2组患者肿瘤区、正常肌肉的ADC值,随机抽取影像学专业医师,对检测出的图像采用双盲法进行评分,使用Kappa分析对医师的评分结果进行检测。结果放化疗治疗后,RESOLVE检测的准确度高于EPI-DWI检测(P<0.05);两种检测方式所显现出的ADC值均小于正常值(P<0.05),且两种检测方式检测出的ADC值差异无统计学意义(P<0.05);RESOLVE评分均在4分以上,高于EPI-DWI评分(P<0.05),RESOLVE图像的Kappa值高于EPI-DWI(P<0.05)。结论采用读出方向上的分段扩散成像技术对鼻咽癌放化疗疗效进行判断,具有较高的准确度,且图像质量显著优于常规平面回波成像-扩散加权成像,对诊断有较好的参考作用,具有一定的临床应用价值。

Objective To analyze the clinical application value of 3.0T MR readout segmented diffusion imaging in radiotherapy and chemotherapy of NPC.Methods A total of 300 nasopharyngeal carcinoma patients admitted to Changhai Hospital Affiliated to Naval Military Medical University from August 2013 to June 2018.ADC(apparent diffusion coefficient)and ROI(Region of Interest)values of all patients were basically the same before treatment,with no statistical significance(P>0.05).All the patientswere randomly divided into two groups:control group(n=150)and observation group(n=150),and they received MRI examinations after radiotherapy and chemotherapy.The control group was detected by EPI-DWI(con-ventional plane echo imaging-diffusion weighted imaging).The observation group was tested by RESOLVE(Piecewise im-aging technique in the readout direction).The ADC values of tumor areas and normal muscles of patients in the two groups were investigated and compared.Professional imaging physicians were randomly selected to score the detected images by double-blind method.Kappa analysis was used to test the scoring results of physicians.Results After radiotherapy and chemo-therapy,The accuracy of RESOLVE was higher than that of EPI-DWI(P<0.05);ADC values of the two detection methods were lower than the normal value(P<0.05),And there was no significant difference in ADC values detected by the two detection methods(P<0.05);The RESOLVE score was above 4 points,higher than that of EPI-DWI(P<0.05),and the Kappa value of RESOLVE image was higher than that of EPI-DWI(P<0.05).Conclusion The piecewise imaging technique in the readout direction has a high accuracy in judging the efficacy of radiotherapy and chemotherapy for nasopharyngeal car-cinoma,and the image quality is significantly better than that of conventional plane echo-diffusion weighted imaging,which has a good reference for diagnosis and has certain clinical application value.