基于NordicICE三维立体ROI法研究鼻咽癌放疗后颞叶脑白质灌注损伤  

Application of the NordicICE 3D ROI method in temporal lobe white matter perfusion injury after nasopharyngeal carcinoma radiotherapy

作　　者：胡芳[1,2] 曾童 王力 阳腾飞 周廷 林赞 邱士军 曹勇[5] 吴涛 HU Fang;ZENG Tong;WANG Li;YANG Tengfei;ZHOU Ting;LIN Zan;QIU Shijun;WU Tao(Key Laboratory of Medical Imaging and Artificial Intelligence of Hunan Province of College of Medical Imaging Laboratory and Rehabilitation in Xiangnan University,Chenzhou Cognitive Degeneration Brain Disease Early Warning Technology Research and Development Center of Affiliated Hospital of Xiangnan University,Chenzhou 423000,China)

机构地区：[1]湘南学院医学影像检验与康复学院医学影像人工智能湖南省重点实验室,湖南郴州423000 [2]湘南学院附属医院郴州市认知相关脑疾病预警技术研发中心,湖南郴州423000 [3]广州中医药大学第一附属医院影像科,广东广州510415 [4]南方医科大学南方医院影像科,广东广州510515 [5]湘南学院第一附属医院影像医学中心,湖南郴州423000

出　　处：《中国中西医结合影像学杂志》2023年第5期519-524,共6页Chinese Imaging Journal of Integrated Traditional and Western Medicine

基　　金：湖南省自然科学基金青年项目(湘基金委[2020]1号:2020JJ5524);湖南省卫生健康委员会一般资助项目(202209043844);湖南省科学技术厅临床医疗技术创新引导项目(2021SK52207);郴州市科技局科研项目(zdyf201809);湘南学院校级科研课题(湘南学院校发[2022]96号:2022JX37)。

摘　　要：目的:采用后处理软件NordicICE(v4.0.3)基于三维立体ROI法研究鼻咽癌放疗后患者双侧颞叶白质灌注变化。方法:选取鼻咽癌患者38例,分为放疗前控制(PC)组、急性反应期(ARP)组和延迟反应期(DRP)组。采集3组的动态磁敏感对比增强成像(DSC-PWI)和T1结构像数据,采用NordicICE(v4.0.3)软件对图像进行预处理后,于颞叶白质最大层面设置双侧颞叶白质和大脑脚ROI,选择球形立体ROI,在远离颞叶的枕叶白质内各设置1个ROI,批处理提取5个ROI灌注值。比较组间各参数的差异。结果:ARP组双侧颞叶白质ROI的标准化脑血流量(nCBF)值与标准化脑血容量(nCBV)值较PC组均显著升高(均P<0.05);DRP组各ROI与其他2组比较,差异均无统计学意义(均P>0.05)。DRP组左侧颞叶白质ROI的平均传输时间(MTT)值较ARP组显著升高(P<0.05);DRP组5个ROI的达峰时间(TTP)值较PC组均显著升高(均P<0.05);ARP组的大脑脚和双侧枕叶的TTP值均较PC组明显升高(均P<0.05)。结论:鼻咽癌放疗后双侧颞叶脑白质在急性期出现一过性过度灌注状态,在迟发反应期有所恢复。Objective:In this study,the new postprocessing software NordicICE(v4.0.3)was used to study the changes in bilateral temporal lobe white matter perfusion in patients with nasopharyngeal carcinoma after radiotherapy based on the three-dimensional ROI method.Methods:Thirty-eight patients with nasopharyngeal carcinoma were selected and divided into a preradiotherapy control(PC)group,an acute response(ARP)group and a delayed response(DRP)group.Dynamic susceptibility contrast-enhanced perfusion-weighted imaging(DSC-PWI)and T_(1) structural image data were collected.After image preprocessing with NordicICE(v4.0.3),5 spherical ROIs was selected in white matter of the left and right temporal lobe white matter,cerebral pedicle,and the left and right occipital lobe.The normalized cerebral blood flow(nCBF)and the normalized cerebral blood volume(nCBV)of 5 ROIs were extracted by batch processing with this software.The parameters between groups were compared and analyzed.Results:The nCBF and nCBV values of the bilateral temporal lobe in the ARP group were significantly higher than those in the PC group(all P<0.05).The MTT value of left temporal lobe white matter ROI in DRP group was significantly higher than that in ARP group(P<0.05).The TTP values of 5 ROIs in DRP group were significantly higher than those in PC group(all P<0.05).TTP value of cerebral peda and bilateral occipital lobe in ARP group were significantly higher than those in PC group(both P<0.05).The nCBF and nCBV values had no significant differences between the DRP group and the other two groups(all P>0.05).Conclusion:After radiotherapy for nasopharyngeal carcinoma,the bilateral temporal lobe white matter show transient overperfusion in the acute stage and recovered in the delayed reaction stage.

关 键 词：动态磁敏感对比增强成像 鼻咽癌 放射治疗 脑白质 脑灌注 

分 类 号：R739.63[医药卫生—肿瘤]