DTI-TBSS对鼻咽癌患者放疗前后脑白质变化的评价价值  

Value of DTI-TBSS in evaluating changes of white matter in patients with nasopharyngeal carcinoma before and after radiotherapy

作　　者：徐世达 汪庆春 张弘扬 XU Shida;WANG Qingchun;ZHANG Hongyang(Department of Radiology,Lishui Hospital of Traditional Chinese Medicine,Zhejiang Province,Lishui 323000,China)

机构地区：[1]浙江省丽水市中医院放射科,浙江丽水323000

出　　处：《中国医药导报》2021年第13期133-136,共4页China Medical Herald

基　　金：浙江省医药卫生科研面上项目(2018KY315)。

摘　　要：目的探讨磁共振扩散张量成像技术(DTI)-基于纤维束示踪的空间分析(TBSS)对鼻咽癌患者放疗前后脑白质变化的评价价值。方法选取2019年9月—2020年4月在浙江省丽水市中医院检查的鼻咽癌患者34例,行DTI-TBSS分析放疗前后脑白质部分各向异性分数(FA)、平均扩散系数(MD)、λ‖值和λ⊥值。比较患者放疗前及放疗6个月后的简易智力状态检查(MMSE)评分。结果放疗6个月后,患者右侧顶叶白质、右侧枕叶白质和右侧额叶白质FA值均低于放疗前;右侧枕叶白质、右侧颞叶白质、左侧及右侧顶叶白质MD值均高于放疗前;右侧颞叶白质、左侧枕叶白质、左侧颞叶白质,左侧顶叶白质、右侧顶叶白质λ‖值低于放疗前;右侧枕叶白质、左侧额-顶交界区、左侧顶叶白质λ⊥值均高于放疗前,而右侧小脑白质和左侧半卵圆中心λ⊥值均低于放疗前;MMSE评分低于放疗前,差异均有统计学意义(均P<0.05)。右侧枕叶白质FA值(r=0.383,P<0.05)、右侧顶叶白质λ‖值(r=0.391,P<0.05)与放疗后MMSE评分呈正相关,左侧额-顶交界区白质λ⊥值(r=-0.404,P<0.05)、MD值(r=-0.411,P<0.05)与放疗后MMSE评分呈负相关。结论DTI-TBSS可评估鼻咽癌患者放疗后脑白质损害,有助于放射性脑损伤的诊断。Objective To explore the value of magnetic resonance diffusion tensor imaging(DTI)-fiber tract tracer based spatial design(TBSS)in evaluating white matter in nasopharyngeal carcinoma patients before and after radiotherapy.Methods Thirty-four patients with nasopharyngeal carcinoma admitted to Lishui Hospital of Traditional Chinese Medicine,Zhejiang Province from September 2019 to April 2020 were selected.DTI-TBSS was used to analyze the anisotropy score(FA),mean diffusion coefficient(MD),value ofλ‖andλ⊥of white matter before and after radiotherapy.Mini-mental state examination(MMSE)scores were compared before radiotherapy and six months after radiotherapy.Results After six months of radiotherapy,the FA values of white matter in the right parietal lobe,right occipital lobe and right frontal lobe were all lower than those before radiotherapy.The MD values of whit matter in the right occipital lobe,temporal lobes,the left and right parietal lobes were higher than those before radiotherapy.The value ofλ‖in white matter of the right temporal lobe,the left occipital lobe,the left temporal lobe,the left parietal lobe and the right parietal lobe were lower than before radiotherapy.The value ofλ⊥in the right occipital lobe,the left fronto-parietal boundary and the left parietal lobe were all higher than those before radiotherapy,while the value ofλ⊥in the right cerebellum white matter and the left hemioval center were all lower than those before radiotherapy;MMSE score was lower than that before radiotherapy,and the differences were all statistically significant(all P<0.05).The FA value of white matter in the right occipital(r=0.383,P<0.05)and theλ‖value of white matter in the right parietal white matter(r=0.391,P<0.05)were positively correlated with the MMSE score after radiotherapy,while the value ofλ⊥in the left fronto-parietal boundary(r=-0.404,P<0.05)and MD value(r=-0.411,P<0.05)were negatively correlated with the MMSE score after radiotherapy.Conclusion DTI-TBSS can be used to evaluate the white

关 键 词：磁共振扩散张量成像技术 基于纤维束示踪的空间设计 鼻咽癌 放疗 

分 类 号：R739.6[医药卫生—肿瘤]