磁共振成像增强扫描及扩散加权成像在鼻咽癌同步放化疗后疗效评估的价值研究  

Study on the value of enhanced magnetic resonance scanning and diffusion weighted imaging in the evaluation of curative effect after concurrent radiotherapy and chemotherapy

作　　者：黄德尤[1] 黄莉娜 卢德伟[1] 吴为民[1] 李保生[1] 吴英宁[1] 张富亿 罗小鹏[3] 李滢 HUANG Deyou;HUANG Lina;LU Dewei;WU Weimin;LI Baosheng;WU Yingning;ZHANG Fuyi;LUO Xiaopeng;LI Ying(Department of Radiology,Affiliated Hospital of Youjiang Medical College for Nationalities,Baise,Guangxi 533000,China;Department of Oncology,Affiliated Hospital of Youjiang Medical College for Nationalities,Baise,Guangxi 533000,China;Department of Otolaryngology,Affiliated Hospital of Youjiang Medical College for Nationalities,Baise,Guangxi 533000,China;Department of Imaging,First People's Hospital of Changde City,Changde,Hunan 415003,China)

机构地区：[1]右江民族医学院附属医院放射科,广西百色533000 [2]右江民族医学院附属医院肿瘤科,广西百色533000 [3]右江民族医学院附属医院耳鼻喉科,广西百色533000 [4]湖南省常德市第一人民医院影像科,湖南常德415003

出　　处：《现代医药卫生》2021年第7期1101-1104,共4页Journal of Modern Medicine & Health

基　　金：广西壮族自治区卫生健康委员会自筹经费科研课题(Z2011147);右江民族医学院附属医院博士点建议项目(右医附院字2018〔29〕)。

摘　　要：目的研究3.0T磁共振成像(MRI)增强扫描及扩散加权成像(DWI)在鼻咽癌同步放化疗后疗效评估的临床价值。方法收集2016年1月至2019年6月右江民族医学院附属医院收治的鼻咽癌患者305例作为研究对象,患者在放疗前后均行鼻咽部及颈部常规MRI扫描、增强扫描及DWI检查。利用体视觉分区分析法观察放化疗前后肿瘤病灶范围、形态、DWI信号及对周围组织侵犯情况变化,并对转移淋巴结进行测量对比。结果290例肿瘤DWI呈高信号,颈部淋巴结转移例286例,周围结构侵犯249例。同步放化疗后,277例肿瘤DWI信号减低,提示放化疗有效率达95.51%;292例鼻咽癌患者肿瘤原发灶范围不同程度缩小,提示同步放化疗总有效率达95.73%;2种检查方法比较差异均无统计学意义(P>0.05)。影像结果显示,肿瘤病变边界比以前更清晰,侵犯范围有所缩小,有颈部淋巴结肿大的患者其直径较前缩小。同步放化疗前后,剩余9例无明显变化,4例肿瘤范围增大,颈部淋巴结退缩不明显甚至增大,并向颅底侵犯。结论MRI增强扫描及扩散加权成像均可对鼻咽癌同步放化疗后疗效作出有效评价,并能较好地监测鼻咽癌放化疗后肿瘤的消退情况和治疗的敏感性。Objective To study the clinical value of 3.0T enhanced magnetic resonance scanning and diffusion-weighted imaging(DWI)in evaluating the efficacy of concurrent radiotherapy and chemotherapy for nasopharyngeal carcinoma.Methods 305 patients with nasopharyngeal carcinoma admitted to the Affiliated Hospital of Youjiang Medical College for Nationalities from January 2016 to June 2019 were collected as the research object.Before and after radiotherapy,patients received routine MRI scans,enhanced scans,and DWI examinations of the nasopharynx and neck.The volumetric visual area analysis method was used to observe the tumor lesion range,morphology,DWI signal and the changes in the surrounding tissues before and after radiotherapy and chemotherapy,and the metastatic lymph nodes were measured and compared.Results 290 patients showed hyperintensity on DWI,286 had cervical lymph node metastasis,and 249 had peripheral structure invasion.After concurrent radiotherapy and chemotherapy,the DWI signal of 277 tumors was reduced,indicating that the effective rate of radiotherapy and chemotherapy was 95.51%.The range of primary tumors in 292 patients with NPC was reduced to varying degrees,suggesting that the total effective rate of concurrent radiotherapy and chemotherapy was 95.73%.There was no statistically significant difference between the two inspection methods(P>0.05).The imaging results showed that the boundaries of the tumor lesions were clearer than before,and the scope of invasion was reduced.Patients with enlarged cervical lymph nodes had a smaller diameter than before.Before and after concurrent radiotherapy and chemotherapy,the remaining 9 cases had no significant changes.In 4 cases,the tumor size was enlarged,the cervical lymph nodes were not retreated significantly or even enlarged,and invaded the skull base.Conclusion Both MRI-enhanced scanning and diffusion-weighted imaging can effectively evaluate the efficacy of simultaneous radiotherapy and chemotherapy for nasopharyngeal carcinoma,and can better monitor the tumo

关 键 词：鼻咽癌 同步放射化疗 增强扫描 扩散加权成像 疗效评价 

分 类 号：R818.04[医药卫生—放射医学]