鼻咽癌磁共振灌注定量参数及ADC值与T分期的关系  

Correlation of MRI perfusion quantitative parameters and ADC value with the T stage of nasopharyngeal carcinoma

作　　者：于小平[1,2] 李飞平[1] 卢强[1] 胡英[3] 王晖[3] 

机构地区：[1]中南大学湘雅医学院附属肿瘤医院(湖南省肿瘤医院)放诊科,长沙410013 [2]中南大学湘雅三医院放射科 [3]中南大学湘雅医学院附属肿瘤医院(湖南省肿瘤医院)放疗科,长沙410013

出　　处：《放射学实践》2014年第11期1282-1285,共4页Radiologic Practice

基　　金：湖南省科技厅资助课题(2010FJ3097);中南大学湘雅医学院附属肿瘤医院(湖南省肿瘤医院)资助课题(A2012-01)

摘　　要：目的:探讨鼻咽癌(NPC)磁共振灌注成像(PWI)定量参数及扩散加权成像(DWI)参数ADC值与T分期之间的相关性。方法:对94例NPC初治患者行PWI、DWI和T分期,分析PWI参数及ADC值与T分期之间的相关性,比较高低T分期NPC之间各MR参数值的差异。结果:T分期分别与Ktrans(r=0.226,P=0.029)和Ve(r=0.553,P=0.000)呈正相关,与Kep呈负相关(r=-0.350,P=0.001)。未发现T分期与fPV(r=-0.122,P=0.240)及ADC值(r=-0.056,P=0.592)之间存在线性相关。Ktrans、Kep和Ve值在Thigh组(T3和T4期NPC)分别为(0.386±0.171)、(1.333±0.436)min-1和(0.302±0.107),在Tlow组(T1和T2期NPC)分别为(0.313±0.115)min-1、(1.552±0.472)min-1和0.219±0.102,两组间的差异有统计学意义。fPV和ADC值在Thigh组分别为(0.017±0.021)和(0.935±0.144)×10-3s/mm2,在Tlow组分别为(0.019±0.018)和(0.950±0.196)×10-3s/mm2,两组间的差异无统计学意义。与Ktrans和Kep值相比,Ve值在判别Thigh组和Tlow组上诊断效能最大,其敏感性为91.8%、特异性为63.2%。结论:PWI定量参数可以反映不同T分期NPC在内部微循环灌注上的差异,而ADC值难以区分不同T分期NPC之间在水分子扩散方面的差别。Objective：To evaluate the potential correlation of the magnetic resonance diffusion-weighted imaging （DWI）parameters and perfusion-weighted imaging （PWI）parameters with the T stage of nasopharyngeal carcinoma （NPC）.Methods：Ninety-four newly diagnosed NPC patients received DWI and PWI examination.Spearman correlation coef-ficients were obtained to evaluate the potential correlations between MR parameters of primary NPC lesions and clinical T stage based on Chinese 2008 Staging System.Results：Ktrans（r= 0.226,P= 0.029）and Ve （r= 0.553,P= 0.000）showed positive correlation with T stage respectively.Kep revealed negative correlation with T stage （r= -0.350,P= 0.001）.No correlation was found either between fPV （r= -0.122,P= 0.240）or apparent diffusion coefficient （ADC）（r= -0.056, P= 0.592）with T stage.Compared with Tlow（T1 and T2 stage NPC）group,Thigh（T3 and T4 stage NPC）group had signif-icantly higher Ktrans value [（0.386±0.171）vs （0.313±0.115）min-1 ],higher Ve value （0.302±0.107 vs 0.219±0.102） and lower Kep value [（1.333±0.436）vs （1.552±0.472）min-1 ].The fPV and ADC value in Thigh group was （0.017± 0.021）and （0.935±0.144）×10^-3s/mm2 respectively.The fPV and ADC value in Tlow group was （0.019±0.018）and （0.950±0.196）×10^-3 s/mm2 respectively.No significant difference in fPV or ADC value was found between Thigh group and Tlow group.Compared with Ktransand Kep,Ve was most powerful for T staging with sensitivity of 91.8% and specificity of 63.2% based on the receiver operating characteristic （ROC）curve.Conclusion：PWI quantitative parameters may act as imaging biomarkers for non-invasively assessing the tumor microstructure in NPC with different T stage.Whereas,ADC value may have difficulty in evaluating the difference of water molecular diffusion motion between NPC primary lesions with different T stages.

关 键 词：鼻咽肿瘤 肿瘤分期 扩散加权成像 灌注加权成像 

分 类 号：R445.2[医药卫生—影像医学与核医学] R739.6[医药卫生—诊断学]