DCE-MRI联合3D-pCASL参数对鼻咽癌放化疗近期疗效的评估价值  

Value of DCE-MRI Combined with 3D-pCASL Parameters in Evaluating Short-term Efficacy of Radiochemotherapy for Nasopharyngeal Carcinoma

作　　者：李莹[1] 汪小华[1] 陈霖[1] LI Ying;WANG Xiao-hua;CHEN Lin(Department of Radiology,First Affiliated Hospital of Third Military Medical University,Chongqing 400038,China)

机构地区：[1]第三军医大学第一附属医院放射科,重庆400038

出　　处：《中国CT和MRI杂志》2023年第12期45-47,共3页Chinese Journal of CT and MRI

基　　金：国家自然科学基金资助项目(82202707)。

摘　　要：目的探究动态增强磁共振成像(DCE-MRI)联合三维准连续式动脉自旋标记(3D-pCASL)参数对鼻咽癌放化疗近期疗效的评估价值。方法选取2019年9月至2022年9月于本院接受放化疗治疗的107例鼻咽癌患者为对象,根据实体瘤治疗疗效评价标准(RECIST 1.1)将患者分为完全缓解(CR)组和非CR组。所有患者均于治疗前接受鼻咽部DCE-MRI和3D-pCASL扫描,获得造影剂到达组织时间、造影剂达峰时间(TTP)、最大信号强度值(SI)和肿瘤血流量值(TBF)等参数。比较两组患者DCE-MRI和3D-pCASL参数,受试者工作曲线(ROC)评估DCEMRI、3D-pCASL参数及其联合应用评估鼻咽癌放化疗近期疗效的价值。结果107例鼻咽癌患者中,103例患者完成随访,其中CR组49例,非CR组54例。CR组造影剂到达组织时间短于非CR组,TBF值大于非CR组(P<0.05),两组患者TTP、SI比较无明显差异(P>0.05)。ROC曲线分析结果显示,造影剂到达组织时间、TBF评估鼻咽癌患者放化疗近期疗效的AUC值分别为0.786、0.827,二者联合应用的AUC值为0.848(P<0.05);造影剂到达组织时间、TBF最佳阈值分别为21.66s、144.42mL·100g^(-1)·min^(-1)。结论DCE-MRI和3D-pCASL扫描均能用于鼻咽癌放化疗近期疗效的评估,相关参数联合应用或能提高近期疗效的评估价值,对临床治疗具有较高的指导意义。Objective To investigate the value of dynamic contrast-enhanced magnetic resonance imaging(DCE-MRI)combined with three-dimensional pseudo-continuous arterial spin labeling(3D-pCASL)parameters in evaluating short-term efficacy of radiochemotherapy for nasopharyngeal carcinoma.Methods A total of 107 patients with nasopharyngeal carcinoma who underwent radiochemotherapy in the hospital from September 2019 to September 2022 were selected as the subjects.According to the Response Evaluation Criteria in Solid Tumors(RECIST 1.1),the patients were divided into complete remission(CR)group and non-CR group.All patients underwent DCE-MRI and 3D-pCASL scanning of the nasopharynx before treatment to obtain parameters such as arrival time and time to peak(TT P)of contrast agent,the maximum signal intensity(SI)and tumor blood flow(TBF).The DCE-MRI and 3D-pCASL parameters were compared between the two groups.The value of DCE-MRI and 3D-pCASL parameters and their combination in evaluating short-term efficacy of radiochemotherapy for nasopharyngeal carcinoma was evaluated using the receiver operating characteristic(ROC)curve.Results Of the 107 patients with nasopharyngeal carcinoma,103 completed follow-up,including 49 in the CR group and 54 in the non-CR group.The arrival time of contrast agent in CR group was shorter than that in non-CR group,and TBF was higher than that in non-CR group(P<0.05).There was no significant difference in TT P or SI between groups(P>0.05).ROC curve analysis results showed that the AUC values of arrival time of contrast agent,TBF and combination of the two for evaluating short-term efficacy of radiochemotherapy in patients with nasopharyngeal carcinoma were 0.786,0.827 and 0.848(P<0.05).The optimal thresholds of the arrival time of contrast agent and TBF were 21.66s and 144.42mL·100g^(-1)·min^(-1),respectively.Conclusion Both of DCE-MRI and 3D-pCASL can be used to evaluate short-term efficacy of radiochemotherapy for nasopharyngeal carcinoma.Combined application of relevant parameters may improve the

关 键 词：鼻咽癌 放化疗 动态增强磁共振成像 三维准连续式动脉自旋标记 近期疗效 

分 类 号：R766.3[医药卫生—耳鼻咽喉科] R445.2[医药卫生—临床医学]