鼻咽癌放疗后局部复发或残留的CT与MRI影像表现分析  

Evaluation on CT and MRI image features for the diagnosis of local recurrences or residues of nasopharyngeai carcinoma after radiotherapy

作　　者：薛建秀[1] 段润卿[2] 冷晓明[3] 马成杰[4] 

机构地区：[1]浙江省杭州萧山第一人民医院耳鼻咽喉科,311200 [2]浙江省杭州萧山第一人民医院放射科 [3]广东中医药大学第一附院影像科 [4]北京中医药大学肿瘤血液中心

出　　处：《中国中西医结合耳鼻咽喉科杂志》2007年第4期284-287,共4页Chinese Journal of Otorhinolaryngology in Integrative Medicine

摘　　要：目的探讨CT与MRI影像特征对鼻咽癌放疗后局部复发或残留的诊断价值。方法放疗后3月～2年经CT和/或MRI检查发现异常块影的鼻咽癌患者85例,进行鼻咽局部肿块活检以确定病变性质。活检阴性者继续行CT或MR随访,直至得出最后结论,对比分析CT、MRI影像特征与病理结果的相关性,总结其诊断价值。结果病理活检、CT与MRI随访复查证实41例(41/85,48.2%)为放疗后局部复发或残留,44例(44/85,51.8%)为放疗后改变。CT诊断鼻咽癌放疗后局部复发或残留的敏感性、特异性、准确性分别为61.9%、84.2%、76.3%;MRI分别为69.2%、83.8%、77.8%。结论CT和MRI诊断鼻咽癌放疗后局部复发或残留的准确性相对均较低,但MRI要优于CT,且两者结合可减少误诊率。Objective To explore the feasibility of evaluation on CT and MRI image features for the diagnosis of local recurrences or residues of nasopharyngeal carcinoma （NPC） after radiotherapy. Methods Included in this study were 85 cases of nasopharyngeal carcinoma with abnormal mass image in the nasopharynx as displayed by CT or MRI images obtained 3 months to 2 years after the radiotherapy. Then, biopsy was given to them for making a pathohistological diagnosis to confirm if there was a focus reoccurred or being residue in the nasopharynx. For those with a negative pathohistological finding, CT or MRI image following up was continuously carried out among them, until a certain negative or positive conclusion about the focus making out. At last, a correlative analysis was made to evaluate the feasibility of such a program for the diagnosis of this kind of condition. Results Among this group of cases, 41 were diagnosed with local recurrences or residues of the lesion （41/85,48.2%） and 44 were seen with a kind of post-radiotherapeutic changes （44/85, 51.8% ） in the nasopharynx by pathohistology, CT and MRI. The sensitivity, specificity and accuracy of CT and MRI image evaluation in the diagnosis of recurrence or residue of NPC after radiotherapy were 61.9%, 84.2 %, 76.3 % and 69.2 %, 83.8 %, 77.8 % respectively. Conclusions The accuracy of CT and MRI image evaluation in the diagnosis of recurrence or residue of NPC after radiotherapy is relatively lower, with a little superior diagnostic evaluation for MRI here, while a combination with CT and MRI can reduce the rate of misdiagnosis for such a kind of condition.

关 键 词：鼻咽癌 局部复发 局部残留 CT MRI 诊断 

分 类 号：R739.63[医药卫生—肿瘤]