磁共振-弥散加权成像对喉癌和下咽癌术后放疗后并发症及肿瘤复发的诊断价值  

The diagnostic value of magnetic resonance diffusion-weighted imaging for the complications and recurrence of laryngeal and hypopharyngeal cancer after surgery and radiation therapy

作　　者：凌鑫 张培栋 汪娟 LING Xin;ZHANG Peidong;WANG Juan(Department of Medical Imaging,Changhai Hospital Affiliated to the Second Military Medical University,Shanghai 200433,China;Department of Emergency,Shanghai East Hospital,Shanghai 200438,China)

机构地区：[1]海军军医大学附属长海医院医学影像科,上海200433 [2]上海市东医院急诊科,上海2004380

出　　处：《癌症进展》2020年第10期1005-1008,共4页Oncology Progress

摘　　要：目的探讨磁共振-弥散加权成像(MR-DWI)对喉癌和下咽癌术后放疗后并发症及肿瘤复发的诊断价值。方法对接受术后放疗的200例喉癌和下咽癌患者及100例健康体检者进行磁共振成像(MRI)和MR-DWI检查,比较两种检查方法对肿瘤复发及并发症的检出率,比较肿瘤复发患者、肉芽组织增生患者、感染患者及健康体检者的定量动态增强磁共振(DCE-MRI)参数和DWI信号强度。结果 200例喉癌和下咽癌患者中,肿瘤复发患者68例,肉芽组织增生患者40例,感染患者92例。MR-DWI对肿瘤复发的检出率为41.2%,与MRI的44.2%比较,差异无统计学意义(P﹥0.05)。MR-DWI对肉芽组织增生和感染的检出率均高于MRI检查,差异均有统计学意义(P﹤0.05)。健康体检者的容量转运常数(Ktrans)、速率常数(Kep)以及血管外细胞外间隙容积比(Ve)均低于肿瘤复发患者、肉芽组织增生患者,Ktrans、Kep均低于感染患者,差异均有统计学意义(P﹤0.05);肿瘤复发患者的Ktrans、Kep、Ve均高于肉芽组织增生患者、感染患者,差异均有统计学意义(P﹤0.05)。肿瘤复发患者的血流量(BF)、血容量(BV)均高于肉芽组织增生和感染患者,平均通过时间(MTT)以及达峰时间(TTP)均低于肉芽组织增生和感染患者,差异均有统计学意义(P﹤0.05);肉芽组织增生患者的BF、BV均高于感染患者,差异均有统计学意义(P﹤0.05)。b=50、800 s/mm2时,肿瘤复发患者的DWI信号强度均低于肉芽组织增生患者、感染患者和健康体检者(P﹤0.05)。结论 MR-DWI能够提高喉癌和下咽癌患者术后放疗后并发症及肿瘤复发的检出率,值得在临床诊断中进一步推广和应用。Objective To explore the diagnostic value of magnetic resonance diffusion-weighted imaging(MR-DWI)for complications and recurrence of laryngeal and hypopharyngeal cancer after surgery and radiation therapy.Method Totally,200 patients with laryngeal cancer or hypopharyngeal cancer receiving postoperative radiation therapy and 100 healthy volunteers were examined with magnetic resonance imaging(MRI)and MR-DWI,the detection rates of tumor recurrence and complications in both groups were compared,likewise,the quantitative dynamic contrast-enhanced magnetic resonance(DCE-MRI)parameters and DWI signal intensity among patients with tumor recurrence,with hyperplasia of granulation tissue,with infection and in healthy subjects were also compared.Result Of the 200 cases with laryngeal cancer or hypopharyngeal cancer,68 cases were identified with tumor recurrence,40 cases were with hyperplasia of granulation tissue,and 92 cases were with infections.The detection rate of MR-DWI for tumor recurrence was 41.2%,which was similar to the 44.2%by MRI(P>0.05).The detection rates of hyperplasia of granulation tissue and infection by MRDWI were evidently higher than those by MRI examination(P<0.05).The volume transfer constant(Ktrans),rate constant(Kep)and extravascular extracellular volume fraction(Ve)in healthy volunteers were all lower compared to those with tumor recurrence or hyperplasia of granulation,and the Ktrans and Kep were lower than those in patients with infections(P<0.05);the Ktrans,Kep and Ve in patients with tumor recurrence were significantly higher compared to patients with granulation hyperplasia or infections(P<0.05).Higher blood flow(BF),blood volume(BV)and shorter mean transit time(MTT)and time to peak(TTP)in patients with tumor recurrence were noted compared to those with granulation hyperplasia or infections(P<0.05);the BF and BV in patients with granulation hyperplasia were significantly higher than in those with infections(P<0.05).At b=50,800 s/mm2,the DWI signal intensity in patients with tumor recurrence

关 键 词：磁共振-弥散加权成像 喉癌 下咽癌 并发症 肿瘤复发 诊断价值 

分 类 号：R739.65[医药卫生—肿瘤]