鼻咽癌放射性脑损伤的MR扩散张量成像研究  

Diffusion Tensor Imaging Study in Radiation Induced Brain Injury of Nasopharyngeal Carcinoma During and After the Radiotherapy

作　　者：陈旺生[1] 李建军[1] 洪澜[2] 王奋[3] 邢增宝[1] 李长清[1] 

机构地区：[1]海南省人民医院放射科,海口市570311 [2]海南省人民医院妇科,海口市570311 [3]海南省人民医院放疗科,海口市570311

出　　处：《临床放射学杂志》2010年第6期747-749,共3页Journal of Clinical Radiology

基　　金：海南省自然科学基金资助课题(编号:30717)

摘　　要：目的应用MR扩散张量成像(DTI)监测鼻咽癌放射性脑损伤急性期和亚急性期的颞叶微观结构变化。资料与方法对2006年7月至2009年5月间80例确诊为鼻咽癌并首次接受放射治疗(简称放疗)的患者,在放疗前和接受剂量为20Gy、40Gy、60Gy以及其中放疗结束后的47例第1、2、3个月分别进行常规颅脑MRI和DTI,动态观察不同时间段DTI的表观扩散系数(ADC)和部分各向异性(FA)值的变化趋势,并进行分析。结果自放疗开始至结束后3个月常规颅脑MRI未见异常信号。放疗过程中和放疗结束后3个月ADC值升高、FA值减低,FA值放疗后3个月的降低幅度大于放疗期间的降幅,ADC值和FA值在放疗期间不同剂量阶段差异无统计学意义(P>0.05),放疗后3个月差异具有统计学意义(P<0.05)。结论虽然鼻咽癌放射性脑损伤的急性期和亚急性期常规MRI未见异常,但仍存在微观结构上的变化,导致细胞内外水分子扩散减慢。DTI从分子水平评价放射性脑损伤的优势在亚急性期更明显,为预防不可逆性脑损伤提供客观依据。Objective To monitor the mirco-structure change of the temporal lobes radiation injury of nasopharyngeal carcinoma patients in acute and subacute stages by using MR diffusion tensor imaging（DTI）.Materials and Meth-ods Routine MRI and DTI were performed before and after radiation dosage of 20Gy,40Gy,60Gy in 80 cases and 47cases of those after treatment of the first 3 months respectively with initial diagnosis nasopharyngeal carcinoma clinically from July,2006 to May,2009.The change tendency of the apparent diffusion coefficient（ADC）,and fractional anisotropy（FA）value of DTI were measured and analyzed contrastly in different stages.Results No abnormal signals were detected in all cases.The ADC value increased while the FA value decreased during the whole observed stage,the decreased amplitude of FA value after treatment was larger than during radiotherapy course.The higher ADC value and lower FA value had statistically significant differences between before and after radiotherapy.Conclusion There is mirco-structure changing occurrence in the temporal lobes during and after radiotherapy,though no abnormal signals are detected.DTI can reflect brain injury dynamicly at the molecule level,its superiority is obvious in the subacute stage,it is helpful to provide objective evidence for preventing inreversible injury early.

关 键 词：鼻咽肿瘤 放射治疗 脑损伤 扩散张量成像 

分 类 号：R739.63[医药卫生—肿瘤]