鼻咽癌放射治疗颞叶脑损伤的动态磁共振波谱研究  

Dynamic MRS study on radiation-induced injury of the temporal lobe after nasopharyngeal carcinoma radiotherapy

作　　者：陈旺生[1] 李建军[1] 王奋[2] 邢增宝[1] 

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

出　　处：《中华肿瘤防治杂志》2011年第1期40-42,共3页Chinese Journal of Cancer Prevention and Treatment

基　　金：海南省自然科学基金(30717)

摘　　要：目的:探讨磁共振波谱(MRS)成像在鼻咽癌放射治疗颞叶脑损伤中的应用价值。方法:对2006-07-2009-05期间80例鼻咽癌患者首次接受放射治疗前和接受剂量为20、40和60 Gy放疗剂量时行常规颅脑MR和双侧颞叶MRS成像。波谱成像以T2FLAIR序列为定位图,点分辨法进行多体素采集,动态观察不同剂量时颞叶波谱形态和主要代谢物及比值的变化趋势。结果:所有病例接受放射总剂量60 Gy,MR常规扫描未见明显异常。接受放射剂量20 Gy,部分病例(43/80)波谱形态发生改变,NAA和Cho波峰降低,以NAA更明显,NAA/Cr、Cho/Cr及NAA/Cho值均不同程度降低;40 Gy,大部分病例(56/80)NAA峰高度接近于Cho;60 Gy,67例Cho波峰高于NAA峰,13例Cho峰与NAA峰高度接近。整个治疗过程中,NAA、Cho、NAA/Cr、Cho/Cr及NAA/Cho值随射线剂量增加而降低,三者比值与所接受射线剂量呈负相关,比值差异有统计学意义(P=0.045)。结论:鼻咽癌放射性颞叶脑损伤是动态演变过程,MRS可从物质代谢水平反映不同放疗阶段脑损伤情况。OBJECTIVE： To study the application value of MR spectroscopy （MRS） in the temporal lobe injury caused radiotherapy of nasopharyngeal carcinoma. METHODS： A total of 80 cases with nasopharyngeal carcinoma from July 2006 to May 2009 were involved. Conventional MR scanning and bilateral temporal MRS were performed before and after radiation with dosage of 20, 40 and 60 Gy, respectively. The change tendency of the spectroscopy morphology and the ratios of the three main metabolites were observed and analyzed. RESULTS： No obvious abnormal signal intensities were detected after the total radiation dosage of 60 Gy in all cases. The spectroscopy morphology began changing with NAA and Cho peaks stepping down at the dose of 20 Gy. At the dosage of 40 Gy, the altitude of NAA and Cho peaks became approximation in most of cases（56/80）. Cho peaks were higher than NAA peaks in 67 cases and the two peaks approximated in 13 ca- ses when accepting 60 Gy. NAA, Cho, NAA/Cr, Cho/Cr and NAA/Cho decreased to some extent with the adding of radiation dosages in the whole radiotherapy course, there was negative correlation between the above-mentioned parameters and the dosages of radiation （P = 0. 045）. CONCLUSION： The radiation-induced injury of the temporal lobe after nasopharyngeal carcinoma radiotherapy is a dynamic changing process, MRS can reflect the degree of injury at the metabolism level in different stages of radiation.

关 键 词：鼻咽肿瘤/放射疗法 脑损伤 磁共振波谱学 磁共振成像 

分 类 号：R739.63[医药卫生—肿瘤]