MR扩散加权成像在鼻咽良恶性病变及鼻咽癌T分期中的诊断价值  

The diagnostic value of MR diffusion weighted imaging in benign and ma-lignant lesions of the nasopharynx and nasopharyngeal T staging

作　　者：朱培杨 周玮[2] 黄小燕[2] 

机构地区：[1]浙江省缙云县人民医院放射科,浙江缙云321400 [2]浙江省湖州市中心医院放射科,浙江湖州313000

出　　处：《中国现代医生》2014年第36期55-58,共4页China Modern Doctor

基　　金：浙江省医药卫生科技计划(2012KYB198)

摘　　要：目的探讨MR扩散加权成像(DWI)在鼻咽良恶性病变及鼻咽癌T分期中的诊断价值。方法对56例鼻咽部病变患者采用DWI进行检查,鉴别病变性质并与20例正常对照进行对比,诊断结果与病理结果进行一致性检验,并分析诊断鼻咽癌(NPC)T分期效能及表观扩散系数(ADC)与T分期的相关性。结果 NPC、NPH和正常对照鼻咽壁、斜坡、椎前肌的ADC值均存在显著性差异(P<0.05),NPC、NPH与正常对照鼻咽壁ADC值均存在显著性差异(P<0.05),NPC与NPH鼻咽壁ADC值存在显著性差异(P<0.05),NPC与NPH及正常对照斜坡、椎前肌的ADC值均存在显著性差异(P<0.05)。DWI诊断病变良恶性Kappa值为0.84,灵敏度为97.30%、特异度为94.74%、阳性似然比为18.50、阴性似然比为0.05,与病理结果一致性好。ADC诊断阈值为0.943×10-3mm2/s,ROC曲线下面积为0.873。DWI鼻咽癌T分期的诊断价值较高。ADC值与T分期呈正相关性(r=0.436,P<0.05)。结论 DWI的ADC值对鼻咽部病变良恶性有鉴别价值,ADC值与T分期相关,DWI对NPC的T分期评估有较高的应用价值。Objective To evaluate the diagnostic value of MR diffusion weighted imaging （DWI） in benign and malignant lesions of the nasopharynx and nasopharyngeal T staging. Methods A total of 56 cases patients with nasopharyngeal lesion DWI checks, identification of lesions and 20 cases normal controls were compared with pathological diagnosis consistency test results and the analysis and diagnosis of NPC T staging and AI）C and T stage correlation. Results The differences of NPC, NPH and normal nasopharyngeal wall, slope, ADC values prevertebral muscles had significant differences （P〈0.05）, NPC, NPH with normal nasopharyngeal wall ADC values were significantly different （P〈0.05）, the presence of NPC and NPH nasopharyngeal wall ADC values had significantly difference（P〈0.05）, the difference of NPC and NPH and normal controls slopes, ADC values prevertebral muscles and significant differences （P〈0.05）. DWI diagnosis of benign and malignant lesions Kappa value was 0.84, the sensitivity was 97.30%, specificity was 94.74%, positive likehhood ratio was 18.50, negative likelihood ratio was 0.05, and pathological findings good consistency. ADC diagnostic threshold of 0.943×10^-3 mm^2/s, the area under the ROC curve was 0.873. The diagnostic value of DWI nasopharyngeal carcinoma T stage was higher. ADC value and T stage were positively correlated （r=0.436, P〈0.05）. Conclusion ADC value on DWI nasopharynx discriminating between benign and malignant lesions, is closely associated with T stage, DWI assessments for T staging of NPC.

关 键 词：鼻咽癌 磁共振成像 弥散 表观扩散系数 T分期 

分 类 号：R739.63[医药卫生—肿瘤] R445.2[医药卫生—临床医学]