磁共振灌注成像在鼻咽癌活检中的临床应用及诊断T分期的价值  

Clinical application of PWI in nasopharyngeal carcinoma:endoscopic biopsy guiding and evaluation of T stage

作　　者：唐曦[1] 胡娅[2] 徐炎华[1] 万兵[3] 鲁海涛[4] 吴文泽 

机构地区：[1]华中科技大学同济医学院附属荆州医院肿瘤科,湖北荆州433020 [2]长江大学医学院机能学部 [3]华中科技大学同济医学院附属荆州医院放射科,湖北荆州433020 [4]华中科技大学同济医学院附属荆州医院耳鼻咽喉头颈外科,湖北荆州433020

出　　处：《中华临床医师杂志（电子版）》2011年第13期3751-3755,共5页Chinese Journal of Clinicians(Electronic Edition)

基　　金：湖北省荆州市医疗卫生科技计划(20101PE1-2020081PE1-17)

摘　　要：目的探讨磁共振灌注成像(PWI)指导鼻咽部活检及评价鼻咽癌组织侵犯范围的临床意义。方法将56例鼻咽癌初治患者随机分为两组,A组PWI检查后行活检,B组活检后行PWI检查;分析肿瘤侵犯范围采用MRI及PWI参数Slopemax伪彩图和SI-T曲线来评价。结果 A组和B组第一次鼻咽活检诊断灵敏度具有明显差异(92.9%vs.60.7%,P<0.05),SI-T曲线显示均为速升型;在颅底受侵检出率PWI低于常规MRI,但差异无统计学意义。结论 PWI指导鼻咽癌活检可提高临床诊断率。Objective To explore the clinical significance of magnetic resonance perfusion weighted imaging(PWI) which is used to guide biopsy and evaluate invasion range of NPC.Methods 56 patients with newly diagnosed nasopharyngeal carcinoma were randomized into two groups,group A of 28 cases with biopsy after PWI and group B of 28 cases with PWI after biopsy.The depicting of the invasive extent for each case was evaluated both by conventional MRI and the parameters of PWI,the color of maximal increasing slope(Slopemax) and signal intensity-time curve(SI-T).Results There was a significant statistical difference in the sensitivity of the initial biopsy between the two groups(92.9% vs.60.7%,P<0.05),SI-T in these two groups were both fast-risen type.PWI was inferier than conventional MRI in evaluating invasion of skull base,but the difference was not statistically significant(P>0.05).Conclusions Biopsy guided by PWI imaging improves the diagnosis rate of NPC.

关 键 词：鼻咽肿瘤 磁共振灌注成像 

分 类 号：R739.63[医药卫生—肿瘤]