MSCT双期增强扫描对鼻咽癌放疗后局部复发瘤诊断价值分析

Dual-phase enhanced multi-slice CT scan diagnostic value in post-radiotherapy local recurrent nasopharyngeal carcinoma

目的探讨分析MSCT双期增强扫描对鼻咽癌放疗后局部复发瘤的诊断价值。方法选取经病理证实的19例复发瘤(复发组)和病理或随访证实的24例鼻咽癌放疗后非复发病例(非复发组)进行鼻咽部平扫以及28 s、80 s双期增强扫描(注射速率4.0 ml/s),分别测量感兴趣区各期CT值,采用SPSS 16.0软件进行统计学分析,并绘制ROC曲线。结果鼻咽癌复发组与非复发组平扫CT值差异无统计学意义(P>0.05),增强扫描28 s、80 s两期CT值差异均存在统计学意义(P<0.05)。以增强扫描第一期相(28 s)病灶增强CT值≥60.4 HU为临界值,诊断复发瘤的敏感度为73.70%,特异度为70.80%;以增强扫描第二期相80 s增强CT值≥61.35 HU为临界值,诊断复发瘤的敏感度为68.40%,特异度为70.80%。结论鼻咽癌MSCT双期增强扫描有助于对鼻咽癌局部复发瘤的定性诊断。

Objective To study the diagnostic value of dual-phase multi-slice CT(MSCT)in the post-radiotherapy local recurrence of nasopharyngeal carcinoma.Methods 19 patients with pathological confirmed recurrence tumor and 24 patients of NPC with phthology or follow-up confirmed post-radiotherapy non-recurring were performed nasopharyngeal CT plain scan and dual-phase MSCT at 28 s and 80 s(injection rate 4.0 ml/s).CT values of each phase of the area of interest were measured respectively,and the SPSS 16.0 software was used for statistical analysis and the ROC curve was drawn.Results There was no significant difference in plain scan CT value between the recurrent nasopharyngeal carcinoma group and the non-recurrent group(P>0.05).We observed a significant difference in CT value between the period enhanced scan 28 s and the period enhanced scan 80 s(P<0.05).The enhanced CT value of lesion was≥60.4 HU as the critical value in the first period(28 s)of enhanced scan,the sensitivity and specificity for the diagnosis of recurrent tumors were 73.70%and 70.80%respectively.The enhanced CT value was≥61.35 HU as the critical value in the second period(80 s)of enhanced scan,the sensitivity and specificity for the diagnosis of recurrent tumors were 68.40%and 70.80%respectively.Conclusion The dual-phase MSCT in nasopharyngeal carcinoma is helpful for qualitative diagnosis of local recurrence of nasopharyngeal carcinoma.