鼻咽癌局部复发的MRI表现及颈部影像报告和数据系统的应用  

MRI diagnosis of local recurrent nasopharyngeal carcinoma and a preliminary study of neck imaging reporting and data systems

作　　者：王志龙[1] 王星蕊 钟柱 汪泽燕[1] 张丽萍[1] 肖学红[1] WANG Zhilong;WANG Xingrui;ZHONG Zhu;WANG Zeyan;ZHANG Liping;XIAO Xuehong(Departmentof Radiology,Zhongshan People’s Hospital,Zhongshan,Guangdong Province 528403,China)

机构地区：[1]中山市人民医院放射科,广东中山528403

出　　处：《实用放射学杂志》2022年第5期717-721,共5页Journal of Practical Radiology

摘　　要：目的探讨鼻咽癌局部复发(LRNPC)的MRI表现特征以及颈部影像报告和数据系统(NI-RADS)的诊断价值。方法回顾性分析118例经病理或MRI与临床随访确诊LRNPC的MRI表现,所有病例进行常规MRI平扫和增强扫描,其中83例行扩散加权成像(DWI)扫描,应用NI-RADS对LRNPC与对照组102例治疗后改变(PTC)及其前片进行评分,评价NI-RADS评分及其变化(ΔNI-RADS)对LRNPC的诊断效能。结果LRNPC分为单纯黏膜型(24例)、浸润肿块型(94例),前者表现为鼻咽黏膜不均匀增厚11例、鼻咽黏膜不均匀增厚伴黏膜小结节13例,后者表现为实性肿块(84例)、囊实性肿块(7例)、囊性肿块(3例)。LRNPC、PTC的NI-RADS评分如下:1(0、87)、2a(12、3)、2b(2、11)、3(40、1)、4(64、0),ΔNI-RADS为0(10、96)、+1(39、4)、+2(44、0)、+3(13、0);以NI-RADS≥3、ΔNI-RADS≥1作为诊断LRNPC的阈值,NI-RADS、ΔNI-RADS的诊断敏感性、特异性、准确性分别为88.14%、99.02%、93.18%和90.57%、96.00%、93.20%。结论LRNPC的MRI表现复杂多变,NI-RADS有良好的诊断效能,充分认识LRNPC的MRI表现特征,应用NIGAAB2RADS表达肿瘤复发的怀疑程度,可作出正确诊断。Objective To study the MRI feature of local recurrent nasopharyngeal carcinoma(LRNPC),and to investigate the diagnostic value of neck imaging reporting and data systems(NI-RADS).Methods MRI characteristics were retrospectively reviewed in 118 cases with LRNPC confirmed by pathology or by the outcome of clinical and MRI follow-up,all patients underwent conventional MRI plain scan and enhanced scan,and 83 cases were scanned with diffusion weighted imaging(DWI).We utilized NI-RADS to evaluate the score of LRNPC and the control group of posttreatment changes(PTC)in 102 cases and their previous MRI,to investigate the diagnostic efficiency of NI-RADS score and interval change of NI-RADS(ANI-RADS)for diagnosis of LRNPC.Results LRNPC was divided into two types,exclusive involvement of the nasopharyngeal mucosa was seen in 24 cases,and infiltrative mass in 94 cases.The former showed asymmetrical mucosal thickening in 11 cases and asymmetrical mucosal thickening accompanied with mucosal nodule in 13 cases.The latter showed solid mass in 84 cases,mixed cystic and solid mass in 7 cases,and cystic mass in 3 cases.The NI-RADS score of LRNPC and PTC as follows::1(0 versus87),2a(12 versus3),2b(2 versus11),3(40 versus1),4(64 versus0),andtheΔNI-RADSas follows:0(10 versus 96),+1(39 versus 4),+2(44 versus 0),+3(13 versus 0),respectively.Thelesions were diagnosed as LRNPC withthe cut of f value of NI-RADS≥3 andΔNI-RADS≥1.The diagnostic sensitivity,specificity and accuracy were 88.14%,99.02%,93.18%and90.57%,96.00%and93.20%,respectively.Conclusion The MRI feature of LRNPC is complex and variable,and the diagnostic efficiency of NI-RADS is favorable.Being familiar with the MRI features of LRNPC,and utilizing NI-RADS to convey levels of suspicion of recurrence,we can make a correct diagnosis.

关 键 词：鼻咽癌 局部复发 磁共振成像 颈部影像报告和数据系统 

分 类 号：R739.63[医药卫生—肿瘤] R445.2[医药卫生—临床医学]