磁共振ADC评价鼻咽癌放疗腮腺功能变化的研究

Magnetic resonance ADC evaluation of parotid gland function changes in nasopharyngeal carcinoma radiotherapy

目的通过表观扩散系数(apparent diffusion coefficient,ADC)的变化观察鼻咽癌患者放射治疗后腮腺功能变化,探究两者的相关性。方法选取2020年1月至2022年1月经牡丹江医学院附属红旗医院临床确诊断的48例鼻咽癌患者为研究对象,回顾性分析患者放射治疗治疗前后的腺体ADC情况,并观察同期ADC与放射损伤分级(RTOG/EORTC)标准的相关性。结果放射治疗后3个月时,患者双侧腮腺平均ADC值变化指标高于治疗前,差异有统计学意义(P<0.05);放射治疗后6个月及12个月时,患者ADC值与放射治疗前比较,差异均无统计学意义(P>0.05)。Spearman相关分析显示,放射治疗后3个月时,RTOG/EORTC放射损伤分级与同期腮腺的ADC值呈显著正相关(P<0.001);放射治疗后6个月及12个月时,RTOG/EORTC放射损伤分级与同期腮腺的ADC值相关性较差(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,表观扩散系数变化与放射治疗后放射损伤分级存在一定相关性。

Objective To observe the changes of parotid gland function in patients with nasopharyngeal carcinoma after radiotherapy through the change of apparent diffusion coefficient(ADC),and to explore the correlation.Methods A total of 48 patients with nasopharyngeal carcinoma who were clinically diagnosed and confirmed by Hongqi Hospital Affiliated to Mudanjiang Medical College from January 2020 to January 2022 were selected for the study to gland ADC of patients before and after radiation therapy treatment of the patients and to observe the correlation between ADC and radiation damage grading(RTOG/EORTC)criteria during the same period.Results At 3 months after radiation treatment,the mean ADC values of the parotid gland were higher than those before treatment,and the difference was statistically significant(P<0.05);at 6 and 12 months after radiation treatment,compared with those before radiation treatment,the ADC values were not statistically significant(P>0.05).Spearman correlation analysis showed that at 3 months after radiation treatment,the RTOG/EORTC radiation damage grading was positively correlated with the ADC values of the parotid gland at the same time(P<0.001).The correlation between RTOG/EORTC radiation damage classification and ADC values of the parotid gland at 6 and 12 months after radiation treatment was poor(P>0.05).Conclusion The quantitative index of ADC value can reflect the changes of parotid gland function in different stages of radiotherapy in patients with nasopharyngeal carcinoma,and there is a certain correlation between the change of apparent diffusion coefficient and the grade of radiation damage after radiotherapy.