3.0 T磁共振表观扩散系数在鼻咽癌放疗后腮腺功能变化相关性评估中的应用

Application of apparent diffusion coefficient on 3.0T MRI in evaluating the correlation of parotid gland function changes after radiotherapy for nasopharyngeal carcinoma

目的通过表观扩散系数(ADC)值的量化指标,探讨磁共振表观扩散系数在鼻咽癌放疗后腮腺功能变化相关性评估中的应用价值。方法选取2020年1月至2021年1月间牡丹江医学院附属红旗医院及牡丹江肿瘤医院收治的经临床确定诊断并接受放射治疗的72例鼻咽癌患者。在治疗过程中同期均行磁共振扫描、弥散功能成像并后处理获取ADC值相关数据。比较治疗过程中不同阶段根据RTOG/EORTC放射性损伤分级标准评分值与腮腺的表观扩散系数值对应情况的相关性,并比较同期不同照射累计剂量情况下腮腺ADC值情况的相关性研究。结果患者接受放射治疗过程中及治疗结束后ADC值变化与RTOG/EORTC放射损伤分级标准评分具有相关性,当RTOG/EORTC放射性损伤分级标准评分较高时对应ADC值较高;且同期腮腺累计照射剂量值越大,ADC值会越高,差异有统计学意义(P<0.05)。结论ADC值的量化指标可以反映鼻咽癌患者接受放疗不同阶段的腮腺功能变化情况,DWI可以在临床治疗过程中提供一种无创、无潜在放射性损伤的影像检查技术手段,以便及时提供较早评估腺体功能情况的技术。

Objective To investigate the value of apparent diffusion coefficient(ADC)in evaluating the correlation of parotid gland function changes after radiotherapy for nasopharyngeal carcinoma(NPC)through the quantitative index of apparent diffusion coefficient(ADC)value.Methods From January 2020 to January 2021,72 patients with nasopharyngeal carcinoma diagnosed clinically and treated with radiotherapy in the Hongqi Hospital Affiliated to Mudanjiang Medical College and Tumor Hospital of Mudanjiang City were selected.Patients underwent magnetic resonance scanning,diffusion function imaging,and post-processing to obtain ADC values during the treatment.The correlation between the score values according to RTOG/EORTC radiation injury grading criteria and the parotid gland's apparent diffusion coefficient(ADC)values at different stages during treatment was compared;the correlation between the ADC values of the parotid gland at different cumulative doses of irradiation during the same period was compared.Results There was a correlation between the change of ADC value and RTOG/EORTC radiation injury grading criteria score during and after radiotherapy.When the RTOG/EORTC radiation injury grading criteria score was higher,the ADC value was higher.The larger the cumulative irradiation dose value of the parotid gland in the same period,the higher the ADC value,with statistical significance.Conclusion The quantitative index of apparent diffusion coefficient(ADC)can reflect the changes in parotid gland function in patients with nasopharyngeal carcinoma at different stages of radiotherapy.DWI can provide a noninvasive imaging technique without potential radiation damage during clinical treatment to provide a technique for early assessment of glandular function in time.