体素内不相干运动扩散加权成像与动脉自旋标记技术在鼻咽癌不同分期中的扩散和灌注特征  

Investigating the diffusion and perfusion characteristics of intravoxel incoherent motion diffusion-weighted imaging and arterial spin labeling in different stages of nasopharyngeal carcinoma

作　　者：廖丽萍 廖海 罗宁斌[1] 李强[1] 金观桥[1] 韦波[1] LIAO Li-ping;LIAO Hai;LUO Ning-bin(Department of Medical Imaging,Guangxi Medical University Cancer Hospital,Nanning 530021,China)

机构地区：[1]广西医科大学附属肿瘤医院医学影像科,南宁530021

出　　处：《放射学实践》2022年第1期29-34,共6页Radiologic Practice

基　　金：吴阶平医学基金会临床科研专项资助基金(320.6750.2020-08-15);广西影像医学临床医学研究中心建设(桂科AD20238096);广西医科大学特色新型智库调研课题项目(GXMUZK20);国家自然科学基金(编号:81760533)。

摘　　要：目的:探讨体素内不相干运动扩散加权成像(IVIM-DWI)与三维准连续动脉自旋标记(3D pCASL)技术在鼻咽癌临床分期中的应用价值。方法:搜集2019年10月-2020年10月我院确诊为鼻咽癌的初诊患者100例,所有患者均行鼻咽部MRI常规序列、IVIM-DWI和3D pCASL序列扫描,并对患者进行临床总分期、TNM分期(AJCC第8版分期系统)及高、低级别分组。分析IVIM-DWI相关参数真实扩散系数(D)、灌注相关扩散系数(D^(*))、灌注分数(f)值及3D pCASL参数最大血流量(BF_(max))值与鼻咽癌各临床分期间的相关性及高、低级别组间各参数的差异。结果:T分期与D值呈负相关(r=-0.25,P<0.05),N分期与D值呈负相关(r=-0.31,P<0.05)。临床总分期与D、f值呈负相关(r=-0.41、-0.19,P<0.05)。T分期低级别组的D值显著高于高级别组,N分期低级别组的D、D^(*)值显著高于高级别组,临床总分期低级别组的D、f值显著高于高级别组,而低级别组的BF_(max)值显著低于高级别组,差异均有统计学意义(P值均<0.05)。BF_(max)值与D^(*)值呈负相关(r=-0.052,P>0.05),与f值呈正相关(r=0.043,P>0.05)。D值在鼻咽癌T分期、N分期、临床总分期中的诊断效能较低,但均高于其他参数,ROC曲线下面积分别为0.621、0.642、0.683。结论:IVIM-DW和3D pCASL在鼻咽癌分期中具有一定指导意义,且IVIM-DWI的诊断效能高于3D pCASL。Objective:To investigate the value of intravoxel incoherent motion diffusion-weighted imaging(IVIM-DWI)and three-dimensional pseudo-continuous arterial spin labeling(3D pCASL)in the clinical staging of nasopharyngeal carcinoma(NPC).Methods:A total of one hundred patients diagnosed as NPC from October 2019 to October 2020 in our hospital were enrolled in this study.All patients underwent routine MRI,IVIM-DWI and 3D pCASL sequence scans,and were staged according to general clinical staging as well as TNM staging(based on AJCC 8th edition staging system)and divided into low and high-grade groups.The correlation of IVIM-DWI related parameters,including pure molecular diffusion(D),perfusion-related diffusion coefficient(D^(*))and perfusion fraction(f),and values of maximum blood flow(BF_(max))derived from 3D pCASL with different NPC clinical stages were analyzed and the difference of the above values between the high and low-grade groups was compared.Results:T staging was negative correlated with D value(r=-0.25,P<0.05),and N staging was negative correlated with D value(r=-0.31,P<0.05).The total clinical staging was negative correlated with D and f values,respectively(r=-0.41 and-0.19,respectively,both P<0.05).The D value of low-grade group was significantly higher than that of high-grade group in T staging,the D and D^(*) values of the low-grade group were significantly higher than that of high-grade group in N staging,the D and f values of low-grade group were significantly higher than that of high-grade group in total clinical staging,while the BF_(max) value of the low-grade group was significantly lower than that of high-grade group,and the differences were all statistically significant(P<0.05).The BF_(max) value was negatively correlated with D^(*) value(r=-0.052,P>0.05),but positively correlated with f value(r=0.043,P>0.05).The diagnostic efficacy of D value in T staging,N staging,and total clinical staging of NPC was low,but it was higher than that of other parameters,and the areas under ROC curve were 0.621,0

关 键 词：鼻咽肿瘤 肿瘤分期 动脉自旋标记 体素内不相干运动 扩散加权成像 

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