动态增强磁共振联合弥散加权成像对鼻咽癌的诊断价值

Diagnostic value of dynamic contrast-enhanced magnetic resonance imaging combined with diffusion weighted imaging for nasopharyngeal carcinoma

目的:探讨动态增强磁共振(DCE-MRI)联合弥散加权成像(DWI)在鼻咽癌(NPC)临床诊断中的价值。方法:回顾性收集2020年2月至2022年3月鹤壁煤业(集团)有限责任公司总医院收治的74例疑似NPC患者为研究对象,患者术前均行DCE-MRI检查,得出病灶部位时间-信号曲线,后进行DWI检查,计算b=1000 s/mm^2时的表观弥散系数(ADC),以手术病理结果为"金标准",比较不同类型病变患者的ADC值,并分析DCE-MRI联合DWI对NPC的诊断效能。结果:经手术病理检查,74例疑似NPC患者中确诊NPC 56例,鼻咽血管纤维瘤5例,咽囊炎9例,颅咽管瘤4例。NPC患者ADC值(0.75±0.09)低于鼻咽血管纤维瘤、咽囊炎、颅咽管瘤患者(1.15±0.12、1.18±0.10、1.19±0.13),P<0.05;DCE-MRI单独诊断NPC结果显示阳性46例,阴性28例,与病理诊断符合率为82.14%;DCE-MRI联合DWI诊断NPC结果显示阳性54例,阴性20例,与病理诊断符合率为96.43%;两者联合诊断NPC的灵敏度、特异度、准确度、阳性预测值以及阴性预测值均高于单一诊断(P均<0.05)。结论:DCE-MRI与DWI联合诊断有助于提高NPC诊断符合率,且具有较高的诊断效能。

Objective To investigate the value of dynamic contrast-enhanced magnetic resonance imaging(DCE-MRI)combined with diffusion weighted imaging(DWI)in the clinical diagnosis of nasopharyngeal carcinoma(NPC).MethodsA total of 74 patients who were suspected of NPC and were admitted to General Hospital of Hebi Coal Industry(Group)Co.,Ltd.from February 2020 to March 2022 were selected as the study subjects.All patients received DCE-MRI examination before operation,and the time-signal curve of the diseased site was plotted.Then,the patients were examined with DWI,and the apparent diffusion coefficient(ADC)when b value was 1000 s/mm^2 was calculated.Surgical and pathological results were taken as the golden standard to compare the ADC values of patients with different types of lesions.The diagnostic performance of DCE-MRI combined with DWI for NPC was analyzed.ResultsSurgical and pathological results confirmed 56 patients with NPC,5 patients with nasopharyngeal angiofibroma,9 patients with pharyngeal bursitis,and 4 patients with craniopharyngioma.The ADC value of patients with NPC(0.75±0.09)was lower than that of patients with nasopharyngeal angiofibroma(1.15±0.12),pharyngeal bursitis(1.18±0.10)and craniopharyngioma(1.19±0.13)P<0.05.DCE-MRI identified 46 patients with NPC and 28 patients without,with a coincidence rate of 82.14%.DCE-MRI combined with DWI diagnosed 54 patients with NPC and 20 patients without,with a coincidence rate of 96.43%.The sensitivity,specificity,accuracy,positive predictive value and negative predictive value of DCE-MRI combined with DWI in the diagnosis of NPC were higher than those of DCE-MRI alone and DWI alone(allP<0.05).ConclusionsDCE-MRI combined with DWI is helpful to improve the diagnostic coincidence rate of NPC,with great diagnostic efficacy.