磁共振弥散加权成像评价鼻咽癌调强放疗唾液腺功能损伤的研究  

Evaluation of salivary gland function damage in nasopharyngeal carcinoma with intensity-modulated radiation therapy by diffusion-weighted magnetic resonance imaging

作　　者：刘桂超[1] 胡学锋[1] 赵海[2] 贺小红[2] 郭建贵 吴海军 LIU Guichao;HU Xuefeng;ZHAO Hai;HE Xiaohong;GUO Jiangui;WU Haijun(Department of Head and Neck Breast Radiotherapy,the First People′s Hospital of Foshan,Foshan,Guangdong 528000,China;Deparment of Radiology,the First People′s Hospital of Foshan,Foshan,Guangdong 528000,China)

机构地区：[1]广东省佛山市第一人民医院头颈乳腺放疗科,528000 [2]广东省佛山市第一人民医院影像科,528000

出　　处：《重庆医学》2019年第18期3143-3147,共5页Chongqing medicine

基　　金：广东省佛山市医学类科技攻关项目(2016AB002401)

摘　　要：目的探讨唾液腺功能损伤与磁共振弥散加权成像技术(DW-MRI)表观扩散系数(ADC)值变化特征的相关性。方法入组28例鼻咽癌患者,分别在放疗前、放疗第4周,放疗结束,放疗后3、6、12个月行口干评级和DW-MRI扫描。DW-MRI扫描包括静息状态和酸刺激后第3、6、9、12、15、18和21分钟。结果放疗第4周、放疗结束口干分级逐步加重,放疗结束至放疗后3个月口干恢复不明显,放疗后6、12个月口干逐步恢复;放疗后12个月与放疗后3个月、放疗结束比较差异均有统计学意义(P<0.01),放疗后12个月与放疗后6个月比较差异无统计学意义(P=0.277)。腮腺和颌下腺放疗第4周、放疗结束ADC值均呈逐步升高,放疗后6、12个月均逐步降低,与放疗结束比较差异有统计学意义(P<0.05)。腮腺放疗前、放疗后6个月和12个月酸刺激第3分钟和第6分钟ADC差异有统计学意义(P<0.05)。颌下腺在放疗前酸刺激第3分钟和第6分钟ADC差异有统计学意义(P<0.05),放疗后6个月和12个月酸刺激第3分钟ADC升高,第6分钟下降,但差异无统计学意义(P>0.05)。结论DW-MRI的ADC值在鼻咽癌调强放疗唾液腺功能损伤评价方面有一定的价值。Objective To explore the correlation between salivary gland function damage and the variation characteristics of apparent diffusion coefficient (ADC) value diffusion-weighted magnetic resonance imaging (DW-MRI). Methods Twenty-eight patients with nasopharyngeal carcinoma were enrolled in the mouth dryness rating and DW-MRI scan before radiotherapy,4th week of radiotherapy,end of radiotherapy,and 3,6 and 12 months after radiotherapy.DW-MRI scan included resting state and 3,6,9,12,15,18,and 21 minutes after acid stimulation. Results At the 4th week of radiotherapy and after radiotherapy,the mouth dryness rating was gradually graded,and the recovery of mouth dryness was not obvious after radiotherapy to 3 months after radiotherapy,which gradually recovered in 3 months after radiotherapy and 6 months after radiotherapy.The differences among 12 months and 3 months after radiotherapy and the end of radiotherapy were statistically significant (P<0.01),while the difference between 12 months after radiotherapy and 6 months after radiotherapy was not statistically significant (P=0.277).ADC values of parotid and submandibular gland gradually increased at the 4th week and the end of radiotherapy,and gradually decreased in 6 months after radiotherapy and 12 months after radiotherapy,with statistically significant difference from that in the end of radiotherapy (P<0.05).ADC value in parotid has a statistically significant difference between the 3rd and 6th minute after acid stimulation before radiotherapy,6 months after radiotherapy and 12 months after radiotherapy (P<0.05).ADC value in submandibular gland has a statistically significant difference in ADC value between the 3rd and 6th minute after acid stimulation before radiotherapy (P<0.05).In 6 and 12 months after radiotherapy,ADC increased at the 3rd minute and decreased at the 6th minute,but the difference was not statistically significant. Conclusion ADC value of DW-MRI has certain value in the evaluation of salivary gland function damage in nasopharyngeal carcinoma with

关 键 词：耳鼻咽喉肿瘤 放射疗法 磁共振成像 唾液腺 放射性损伤 功能评价 

分 类 号：R739.6[医药卫生—肿瘤]