多模态磁共振联合CT在鼻咽癌术前分期诊断中分析

Analysis of Multimodal Magnetic Resonance Imaging Combined with CT in Preoperative Staging Diagnosis of Nasopharyngeal Carcinoma

目的分析多模态磁共振(MRI)+CT在鼻咽癌术前分期诊断中的应用价值。方法回顾性分析2021年1月-2023年1月医院经病理检查确诊的86例鼻咽癌患者临床资料,所有患者入院时均接受多模态MRI成像检查及CT扫描检查。以病理检查结果为金标准,分析CT检查对鼻咽癌术前临床分期的诊断效能,对比不同临床分期的鼻咽癌患者多模态MRI参数,绘制ROC分析多模态MRI联合CT诊断鼻咽癌临床分期的价值。结果86例鼻咽癌患者经病理检查结果显示,Ⅰ期6例(6.98%),Ⅱ期24例(27.91%),Ⅲ期39例(45.35%),Ⅳ期17例(19.77%);以病理检查结果为“金标准”,多模态MRI成像诊断鼻咽癌术前临床分期与病理检查结果一致性极好(Kappa=0.810,P<0.05);CT检查诊断鼻咽癌术前临床分期与病理检查结果一致性理想(Kappa=0.709,P<0.05);中晚期组细胞外间隙体积百分数(V_(e))、速率常数(K_(ep))、运转常数(K_(trens))值高于早期组,表观扩散系数(ADC)值低于早期组(P<0.05);绘制受试者工作特征(ROC)曲线,结果显示,V_(e)、K_(ep)、K_(trens)、ADC、CT检查对鼻咽癌临床分期具有一定诊断价值(AUC=0.714、0.757、0.880、0.731、0.774),联合诊断价值更高(AUC=0.910)。结论多模态MRI、CT对鼻咽癌术前临床分期均具有一定诊断价值,两种检查方式联合应用诊断价值更高。

Objective To analyze the application value of multimodal magnetic resonance(MRI)+CT in preoperative staging diagnosis of nasopharyngeal carcinoma.Methods To retrospectively analyze the clinical data of 86 patients with nasopharyngeal carcinoma diagnosed by pathological examination in the hospital from January 2021 to January 2023,all of whom received multimodal MRI imaging examination and CT scanning examination at the time of admission.The diagnostic efficacy of CT examination for preoperative clinical staging of nasopharyngeal cancer was analyzed using the pathological examination results as the gold standard,comparing the multimodal MRI parameters of nasopharyngeal cancer patients with different clinical stages,and drawing ROC to analyze the value of multimodal MRI combined with CT in diagnosing the clinical staging of nasopharyngeal cancer.Results The results of 86 nasopharyngeal cancer patients by pathological examination showed that 6 cases(6.98%)were in stage I,24 cases(27.91%)were in stage II,39 cases(45.35%)were in stage III,and 17 cases(19.77%)were in stage IV;using the pathological examination results as the gold standard,the consistency between the preoperative clinical staging of nasopharyngeal carcinoma diagnosed by multimodal MRI imaging and the results of pathological examination was excellent(Kappa=0.810,P<0.05);CT examination for diagnosing preoperative clinical staging of nasopharyngeal carcinoma was in ideal agreement with pathological examination results(Kappa=0.709,P<0.05);the values of extracellular interstitial volume percentage(V_(e)),rate constants(K_(ep)),and running constants(K_(trens))were higher than those of the early group in the middle and late stage group,and the values of apparent diffusion coefficients(ADCs)were lower than those of the early group(P<0.05);The working characteristics(ROC)curves of the subjects were plotted,and the results showed that V_(e),K_(ep),K_(trens),ADC,and CT examination had some diagnostic value for the clinical staging of nasopharyngeal carcinoma(AUC=0.714,0.757,0.880,0.731,0.774),and the combined diagnostic value was higher(AUC=0.910).Conclusion Multimodal MRI and CT have certain diagnostic value for preoperative clinical staging of nasopharyngeal carcinoma,and the diagnostic value of the two modalities in combination is higher.