磁共振扩散加权成像在鉴别鼻咽部良恶性病变及鼻咽癌T分期的诊断价值  

The diagnostic values of diffusion-weighted imaging in differentiation of benign and malignant lesions of the nasopharynx and nasopharyngeal T staging

作　　者：周玮[1] 顾晓丽[2] 黄小燕[1] 何剑[1] 吴晓[1] 

机构地区：[1]浙江省湖州市中心医院浙江大学湖州医院放射科,浙江湖州313000 [2]复旦大学附属华山医院静安分院放射科,上海200040

出　　处：《医学影像学杂志》2016年第5期783-787,共5页Journal of Medical Imaging

基　　金：浙江省医药卫生一般研究计划项目(编号: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分期的诊断价值。方法对90例鼻咽部病变患者行常规MR及DWI检查,分别从鼻咽部粘膜特征,鼻咽部良恶性病变ADC值进行分析并与20例健康者进行对照,诊断结果与病理结果进行一致性检验;分析DWI对鼻咽癌(NPC)T分期的诊断效能及表观弥散系数(ADC)与T分期的相关性。结果 NPC与NPH在病灶的对称性、厚度及信号强度方面均有显著差异(P<0.05);NPC患者鼻咽壁、斜坡及椎前肌的ADC值与NPH患者及健康对照组均存在显著性差异(P<0.05);NPH患者鼻咽壁的ADC值与健康对照组存在显著性差异(P<0.05)。DWI对鼻咽良恶性病变的诊断结果与病理结果一致性好。DWI对鼻咽癌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 MR扩散加权成像结合测定ADC值有助于对鼻咽部良恶性病变的鉴别诊断以及对NPC的T分期评估。Objective To evaluate the diagnostic vaues of diffusion-weighted imaging（ DWI） in differentiation of benign and malignant lesions of the nasopharynx and nasopharyngeal T staging. Methods 90 patients with nasopharyngeal lesion received routine MRI and DWI. The features of nasopharyngeal mucosa and apparent diffusion coefficient（ ADC） of benign and malignant lesions of the nasopharynx were analyzed and 20 cases were compared with pathological diagnosis consistency test results; the DWI diagnostic efficiency of nasopharyngeal carcinoma（ NPC） T staging and ADC and T stage correlation were analyzed. Results NPC and nasopharyngeal hyperplasia（ NPH） were significant differences in three aspects： symmetry,thickness and signal strength（ P〈0. 05）; ADC values of nasopharyngeal wall,slope and prevertebral muscles in NPC,NPH and normal nasopharyngeal were significant differences（ P〈0. 05）; The ADC values of nasopharyngeal wall in NPH and normal nasopharyngeal were significantly different（ P〈0. 05）. DWI diagnosis of benign and malignant lesions and pathological findings had good consistency. DWI had higher diagnostic efficiency of T stage nasopharyngeal carcinoma and ADC value and T stage were positively correlated（ r = 0. 436,P〈0. 05）. Conclusion ADC values on DWI are beneficial to the differentiation of benign and malignant lesions of the nasopharynx and the assessment of nasopharyngeal T staging.

关 键 词：鼻咽癌 磁共振成像 弥散 表观弥散系数 T分期 

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