单、双指数模型扩散加权成像及动脉自旋标记预测复发性鼻咽癌近期疗效的应用价值  

Application value of mono-and bi-exponential model diffusion weighted imaging and arterial spin labeling in predicting short-term curative effect of recurrent nasopharyngeal carcinoma

作　　者：刘腾 肖磊 韦波[1] 廖海 LIU Teng;XIAO Lei;WEI Bo;LIAO Hai(Medical Imaging Center,Cancer Hospital Affiliated to Guangxi Medical University,Nanning 530021,China)

机构地区：[1]广西医科大学附属肿瘤医院医学影像中心,南宁530021

出　　处：《磁共振成像》2023年第9期63-69,共7页Chinese Journal of Magnetic Resonance Imaging

基　　金：广西科技计划项目(编号:桂科AB23026018、桂科AD20238096);广西自然科学基金(编号:2023GXNSFAA026249)。

摘　　要：目的探讨单、双指数模型扩散加权成像(diffusion weighted imaging,DWI)及三维伪连续动脉自旋标记(three dimensional pseudo-continuous arterial spin labeling,3DpCASL)技术在复发性鼻咽癌近期疗效预测中的潜在价值。材料与方法前瞻性纳入34例复发性鼻咽癌患者,所有患者于治疗前行常规MRI、传统单指数模型DWI检查(b=0、800 s/mm2)和基于体素内不相干运动成像的双指数模型多b值DWI以及3DpCASL检查,治疗结束后行常规MRI检查。根据实体瘤疗效评估标准1.1将患者分为应答组(完全缓解和部分缓解)和无应答组(疾病稳定和疾病进展)。比较两组间表观扩散系数(apparent diffusion coefficient,ADC)、慢速扩散系数(slow diffusion coefficient,Dslow)、快速扩散系数(fast diffusion coefficient,Dfast)、灌注分数(perfusion fraction,f)、肿瘤血流量(tumor blood flow,TBF)和相对肿瘤血流量(relative TBF,rTBF)值之间的差异。同时,根据治疗前后靶病灶退缩情况计算肿瘤消退率,并利用Spearman相关分析探索各参数与肿瘤退缩率之间的相关性。采用AUC值评估各参数的诊断价值。结果应答组基线ADC及Dslow值明显低于无应答组(P<0.001)。应答组基线TBF及rTBF值明显高于无应答组(P<0.001)。治疗前ADC、Dslow值与肿瘤消退率呈负相关,治疗前TBF及rTBF值与肿瘤消退率呈正相关。ROC分析显示,ADC、Dslow、TBF及rTBF预测复发性鼻咽癌近期疗效的AUC值分别为0.944、0.940、0.765、0.779。结论单、双指数模型DWI及3DpCASL参数能准确预测复发性鼻咽癌近期疗效,尤其是ADC和Dslow预测效能最佳,为复发性鼻咽癌近期疗效的早期精准预测提供无创技术手段和有效量化指标。Objective:To investigate the potential value of mono-and bi-exponential model diffusion weighted imaging(DWI)and three dimensional pseudo-continuous arterial spin labeling(3DpCASL)in predicting the short-term curative effect of recurrent nasopharyngeal carcinoma.Materials and Methods:A total of 34 patients with recurrent nasopharyngeal carcinoma who were treated in our hospital were prospectively enrolled.Before treatment,all patients underwent conventional MRI,traditional mono-exponential model DWI(b=0,800 s/mm2)and intravoxel incoherent motion imaging(IVIM)bi-exponential model multi-b-value DWI and 3DpCASL examination,routine MRI examination after treatment.According to Response Evaluation Criteria in Solid Tumors(version 1.1),patients were divided into response group(complete response and partial response)and non-response group(stable disease and progression disease).The differences in apparent diffusion coefficient(ADC),slow diffusion coefficient(Dslow),fast diffusion coefficient(Dfast),perfusion fraction(f),tumor blood flow(TBF),and relative tumor blood flow(rTBF)values were compared between the two groups.Then,the tumor regression rate was calculated according to the regression of the target lesion before and after treatment,and the correlation between each parameter and the tumor regression rate was explored by Spearman correlation analysis.The area under curve of ROC was used to evaluate the diagnostic value of each parameter.Results:The baseline ADC and Dslow value of the response group were significantly lower than those of the non-response group(P<0.001).The baseline TBF and rTBF values of the response group were significantly higher than those of the non-response group(P<0.001).The ADC and Dslow values before treatment were negatively correlated with the tumor regression rate,and the TBF and rTBF values before treatment were positively correlated with the tumor regression rate.ROC analysis showed that the AUC values of ADC,Dslow,TBF and rTBF for predicting the short-term curative effect of recurrent n

关 键 词：鼻咽癌 复发 疗效预测 扩散加权成像 体素内不相干运动 动脉自旋标记 磁共振成像 

分 类 号：R445.2[医药卫生—影像医学与核医学] R739.6[医药卫生—诊断学]