鼻咽黏膜DWI影像特点对于鼻咽良恶性病变判断的价值  

The value of DWI features of nasopharyngeal mucosa in the judgment of benign and malignant lesions in nasopharynx

作　　者：刘延华 李婧[2] 

机构地区：[1]山东省单县人民医院CT室,山东单县274300 [2]山东省单县中心医院CT室,山东单县274300

出　　处：《医学影像学杂志》2015年第11期1925-1928,共4页Journal of Medical Imaging

摘　　要：目的探讨磁共振扩散加权成像(diffusion weighted imaging,DWI)对鼻咽病患的黏膜影像特点对鼻咽良恶性的判断结果,并分析其临床价值。方法选择我院接受治疗的鼻咽病患238例,根据对良恶性诊断的病理结果分为观察组(良性病变组)131例和对照组(恶性病变组)107例。采用DWI扫描测定ADC并分析影像特点,再通过血清测定CEA及CA-199水平。结果观察组具有对称、低信号以及粘膜不厚的病灶比例更高,而对照组多为不对称、高信号以及黏膜增厚病灶。统计对比发现对称性、信号强度以及黏膜厚度的准确度依次为64.29%、67.23%、71.85%,灵敏度依次为55.14%、57.94%、62.61%以及特异性为71.76%、74.81%、79.39%,呈现下降趋势。同时,在b值确定下观察组ADC及BF、BV、PS均显著高于对照组,而血清中CEA、CA-199水平低于对照组。差异均有统计学意义(均P<0.05)。结论DWI诊断中对称性、信号强度以及黏膜厚度均能作为诊断鼻咽良恶性的依据,其中黏膜厚度价值最高。并且ADC水平更高。Objective To explore the value of diffusion weighted imaging（DWI）features of nasopharyngeal mucosa in the judgment of benign and malignant lesions in nasopharynx.Methods 238 patients with nasopharyngeal cancer,who were treated in our hospital from September 2013 to September 2014,were selected in this work.According to pathological results,those patients were divided into observation group（benign group,131cases）and control group（malignant group,107cases）.ADC was determined by DWI scanning,the image characteristics were analyzed,and then,the serum CEA and CA-199 levels were measured.Results In the observation group,the ratio that focus presented with symmetry,low signal,and thin mucosa was higher,whereas,in the control group,focus mostly presented with asymmetry,high signal,and the thickened mucosa.Statistical comparison found that accuracy of symmetry,the signal intensity and the mucosal thickness were 64.29%,67.23%,71.85%,sensitivity of those were 55.14%,57.94%,62.61%,and specificity of those was 71.76%,74.81%,79.39%,respectively,with a trend of decline.At the same time,under the condition of the b value determination,ADC,BF,BV,PS and were significantly higher than those in the control group,while,the CEA and CA-199 level in serum was lower than that of control group.The differences were statistically significant（P 0.05）.Conclusion In the diagnosis by DWI,the symmetry,the signal intensity and the mucosal thickness can be used as the basis for diagnosis of benign and malignant nasopharyngeal lesions,of which the mucosal thickness possesses the highest value.And also,the level of ADC was higher,providing high value for benign and malignant nasopharyngeal lesions in clinic.

关 键 词：鼻咽黏膜 磁共振扩散加权成像 良恶性病变 

分 类 号：R739.6[医药卫生—肿瘤] R445.2[医药卫生—临床医学]