鼻咽癌放射性脑损伤迟发反应期的磁共振波谱研究  

MRS Study on Radiation-induced Injury of the Brain in Delay-reaction Stage after Nasopharyngeal Carcinoma Radiotherapy

作　　者：陈旺生[1] 李建军[1] 洪澜[2] 王奋[3] 邢增宝[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》2011年第4期481-484,共4页Journal of Clinical Radiology

基　　金：海南省自然科学基金资助项目(编号:30717)

摘　　要：目的探讨磁共振波谱（magnetic resonance spectroscopy,MRS）成像在鼻咽癌放射治疗后迟发反应期的应用价值。资料与方法对同期80例确诊为鼻咽癌并首次接受放射治疗（简称放疗）的患者进行放疗前、放疗结束时和放疗结束后的47例患者第3、6、12个月分别行常规MR I和MRS成像。MRS成像以T2液体衰减反转恢复（FLAIR）序列作为定位图,点分辨法进行多体素采集,观察放疗后不同时期主要代谢物的变化趋势,并进行分析。结果 47例各阶段MR I常规扫描未见明显异常。放疗结束时,N-乙酰天门冬氨酸（NAA）/肌酸（Cr）、胆碱（Cho）/Cr和NAA/Cho比值降低,放疗结束后3个月,三者比值进一步减小达到最低点,但幅度小于放疗过程中,与放疗前比较差异具有统计学意义（P〈0.05）;放疗结束后3~12个月三者比值呈上升趋势,至第12个月时三者比值均高于放疗结束时,Cho/Cr和NAA/Cho分别接近和略低于放疗前。结论 MRS成像通过监测代谢物的浓度变化,能无创性反映鼻咽癌放射性脑损伤迟发反应期的修复过程。Objective To study the application value of MR spectroscopy（MRS） on the brain injury in delay-reaction stage after nasopharyngeal carcinoma radiotherapy.Materials and Methods Conventional MRI scanning and MRS were performed before and after radiation in 80 cases with nasopharyngeal carcinoma and 47cases of those after treatment of the 3th,6th and 12th month respectively.The changes tendency of the ratios of the main metabolites were analyzed.Resu-lts No obvious abnormal signal intensity was detected from the end of radiation to the 12th month in all cases.NAA/Cr,Cho/Cr and NAA/Cho were decreased at the end of radiotherapy,and went down continually during the first three months after the radiotherapy,then reached the lowest point,which had statistically significant differences compared to that before radiotherapy.At the stage of the 3-12 months after treatment,NAA/Cr,Cho/Cr and NAA/Cho were rising gradually,Cho/Cr value reached closely to the normal level,and NAA/Cr value was little lower than its level before radiotherapy.Conclusion MRS can reflect the course of recovery of radiation-induced injury of the brain in delay-reaction stage after nasopharyngeal carcinoma radiotherapy through monitoring metabolism changes.

关 键 词：鼻咽肿瘤 放射疗法 脑损伤 磁共振波谱 修复 

分 类 号：R739.63[医药卫生—肿瘤]