鼻咽癌放疗后复发与纤维化DE-MRI的特征及病理对照研究  

Dynamic contrast enhanced MRI characteristics of recurrent nasopharyngeal carcinoma and post-radiation fibrosis:correlation of DCE-MRI and pathology

作　　者：李建鹏[1] 邹玉坚[1] 郑晓林[1] 范宪淼[1] 陈婧[2] 

机构地区：[1]东莞市人民医院放射科,广东523059 [2]东莞市人民医院病理科,广东523059

出　　处：《放射学实践》2014年第8期917-920,共4页Radiologic Practice

摘　　要：目的：探讨动态增强MRI技术对鼻咽癌放疗后复发与纤维化的鉴别诊断价值。方法;本研究中鼻咽癌放疗后复发患者15例，放疗后纤维化患者20例，均行三维容积内插法MRI扫描，获取病变区的时间一信号强度曲线（TIC），测量并分析以下指标：MRI信号值（MRI值）、最大对比增强率（MCER）、最大对比增强率的时间（Tmax）。每例患者均取活检进行病理检查。结果：TIC类型：复发组中Ⅱ型（速升-平台型）12例，Ⅲ型（速升-缓降型）3例；纤维化组中I型（速升-缓升型）6例，Ⅱ型3例，Ⅳ型（缓升型）11例。在15～210S各时间点，复发组病灶的MRI值明显高于纤维化组，差异均有统计学意义（F=34．172～370．347，P〈O．001）；而在0S时，两组的MRI值差异无统计学意义（F=1．296，P-0．263）。复发组的MCER为13．64±0．52，明显高于纤维化组（6．50±1．05），两组间差异有统计学意义（F=30．303，P〈0．001）。复发组Tmax明显早于纤维化组。结论：应用MRI动态增强技术分析MRI值、MCER指标可以鉴别诊断鼻咽癌放疗后复发与纤维化。Objective：To investigate the value of dynamic contrast enhanced （DCE） MRI in the differential diagnosis of recurrent nasopharyngeal carcinoma （NPC） and post-radiation fibrosis. Methods： A retrospective study was performed in 15 cases of recurrent NPC and 20 cases of post-radiation fibrosis after radiotherapy. Time-intensity curves （TIC） of these two groups were obtained with FL3D_VIBE sequence. Parameters included MRI signal values, maximal contrast enhance- ment ratio （MCER）,time to MCER （Tmax） were analyzed. Each case underwent biopsy,and diagnosis was confirmed by histopathology. Results：TIC types were categorized as follows： recurrent group, type Ⅱ（12 cases） and type Ⅲ （3 cases） ; post-radiation fibrosis group,type I （6 cases）,type Ⅱ （3 cases） and type IV （11 cases）. At 15～210s time points,MRI signal value of recurrence group were significantly higher than that of fibrosis group with statistic difference （F=34.172～ 370. 347,P〈0. 001） ;while no significant statistic difference could be seen at 0s （F=I. 296,P=0. 263）. The MCER of re- currence group was （13.64 ± 0. 52）, which was obviously higher than that of post-radiation fibrosis group （6.50±1.05） with significant statistic difference （F= 30. 303 ,P〈30. 303）. The Tmax of recurrence group was significantly earlier than that of post-radiation fibrosis group. Conclusion： DCE-MRI is helpful in the differential diagnosis of recurrent nasopharyn- geat carcinoma and post-radiation-fibrosis by analyzing the values of MRI,MCER and time to MCER.

关 键 词：鼻咽部肿瘤 复发 纤维化 磁共振成像 动态增强扫描 

分 类 号：R445.2[医药卫生—影像医学与核医学] R739.8[医药卫生—诊断学]