弥散加权成像及增强CT对下咽癌术后放射治疗后并发症及复发的诊断价值  

Diagnostic value of diffusion weighted imaging and enhanced CT in postoperative complications and recurrence of hypopharyngeal carcinoma after radiotherapy

作　　者：张亚杰[1] 于泽洋[2] 项昆[3] 王卓[1] ZHANG Yajie;YU Zeyang;XIANG Kun;WANG Zhuo(MRI Room,Kailuan General Hospital,Tangshan Hebei 063000;Fourth Department of Hand,Second Hospital of Tangshan,Tangshan Hebei 063000;CT Room,Tangshan Union Medical College Hospital,Tangshan Hebei 063000,China)

机构地区：[1]开滦总医院磁共振室,河北唐山063000 [2]唐山市第二医院手四科,河北唐山063000 [3]唐山市协和医院CT室,河北唐山063000

出　　处：《临床与病理杂志》2023年第7期1400-1406,共7页Journal of Clinical and Pathological Research

基　　金：河北省卫生健康委员会科研课题(20201546)。

摘　　要：目的:探究弥散加权成像(diffusion weighted imaging,DWI)及增强CT对下咽癌术后放射治疗(以下简称“放疗”)后并发症及复发的诊断价值。方法:选择2020年6月至2022年6月在唐山市协和医院接受治疗的122例下咽癌患者作为研究对象。所有下咽癌患者在放疗后进行常规磁共振成像(magnetic resonance imaging,MRI)(包括DWI序列)及增强CT检查。观察、比较下咽癌患者的常规MRI、增强CT的影像学特点;对比肿瘤复发组(n=46)、肉芽组织增生组(n=51)、感染组(n=34)以及正常组(n=17)患者的表观弥散系数(apparent diffusion coefficient,ADC)值;比较DWI、增强CT在诊断下咽癌患者术后并发症及肿瘤复发上的诊断效能。结果:肿瘤复发组、肉芽组织增生组、感染组以及正常组患者的ADC值按照从低到高依次为肿瘤复发组<肉芽组织增生组<感染组<正常组;多组间、2组间比较差异均有统计学意义(均P<0.05)。DWI在诊断下咽癌并发症以及肿瘤复发上的敏感度、特异度、准确度以及阳性预测值、阴性预测值均明显高于增强CT,差异均有统计学意义(均P<0.05)。结论:DWI在诊断下咽癌术后放疗后并发症及肿瘤复发上的诊断效能均明显高于增强CT,值得在临床诊断中进一步推广和应用。Objective:To explore the diagnostic value of diffusion weighted imaging(DWI)and enhanced computed tomography (CT) in postoperative complications and recurrence of hypopharyngeal carcinoma after radiotherapy. Methods: A total of 122 patients with hypopharyngeal cancer treated in Tangshan Union Medical College Hospital from June 2020 to June 2022 were selected as the research subjects. The routine magnetic resonance imaging (MRI) (including DWI sequence) and enhanced CT were performed in all patients. The imaging features of routine MRI and enhanced CT in patients with hypopharyngeal carcinoma were observed and compared. The apparent diffusion coefficient (ADC) values of patients with tumor recurrence group (n=46), granulation tissue hyperplasia group (n=51), infection group (n=34), and normal group (n=17) were compared. The diagnostic efficacy of DWI and enhanced CT in the diagnosis of postoperative complications and tumor recurrence of hypopharyngeal cancer patients were also compared. Results: The ADC values from low to high were: tumor recurrence group<granulation tissue hyperplasia group<infection group<normal group;there were significant differences between groups and between groups (all P<0.05). The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of DWI in the diagnosis of hypopharyngeal cancer complications and tumor recurrence were significantly higher than those of contrast-enhanced CT (all P<0.05). Conclusion: The diagnostic efficiency of DWI in the diagnosis of postoperative radiotherapy complications and tumor recurrence of hypopharyngeal carcinoma is significantly higher than that of contrast-enhanced CT, which is worthy of further promotion and application in clinical diagnosis.

关 键 词：磁共振成像 弥散加权成像 增强CT 下咽癌 放射治疗 术后并发症 肿瘤复发 

分 类 号：R730.44[医药卫生—肿瘤] R739.63[医药卫生—临床医学]