常规磁共振成像影像特征在鼻咽癌预后预测中的研究进展  

Research progress of conventional MRI characteristics in prognostic prediction of nasopharyngeal carcinoma

作　　者：杨凡 林蒙 张红梅 YANG Fan;LIN Meng;ZHANG Hongmei(Department of Diagnostic Radiology,National Cancer Center,National Clinical Research Center for Cancer,Cancer Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing 100021,China)

机构地区：[1]国家癌症中心/国家肿瘤临床医学研究中心/中国医学科学院北京协和医学院肿瘤医院影像诊断科,北京100021

出　　处：《磁共振成像》2024年第8期218-223,共6页Chinese Journal of Magnetic Resonance Imaging

摘　　要：鼻咽癌(nasopharyngeal carcinoma,NPC)是一种起源于鼻咽黏膜柱状上皮的恶性肿瘤。目前,临床上主要根据磁共振成像(magnetic resonance imaging,MRI)上原发肿瘤的侵犯程度以及颈部淋巴结大小和位置来确定患者治疗方案,但仍有约10%~30%患者在治疗后发生疾病进展。目前,多功能MRI技术展现出了比常规MRI技术更好的预后预测性能,但由于常规MRI检查具有分辨率高,稳定性好以及普及性广的特点,其在临床应用中的价值不可忽视。且近年来,多项研究细致探究了NPC颅底结构侵犯情况(如颅底骨质侵犯,软组织浸润等)以及转移淋巴结的其他形态学特征(如包膜外侵,淋巴结坏死等)在NPC预后预测中的价值,且将某些常规MRI特征加入目前第八版分期能够显著提高预测性能。因此,本研究就常规MRI[如T2WI、对比增强T1WI(contrast-enhanced T1WI,CE-T1WI)、弥散加权成像(diffusion weighted imaging,DWI)]的多维度原发灶和淋巴结特征在NPC预后预测中的价值进行综述,以为临床诊疗提供可靠的依据。Nasopharyngeal carcinoma(NPC)is a malignant tumor that originates from the columnar epithelium of the nasopharyngeal mucosa.Currently,the treatment regime for patients with NPC is mainly based on the degree of invasion of the primary tumor and the size and location of cervical lymph nodes on magnetic resonance imaging(MRI),but disease progression still occurs in approximately 10%-30%of patients after treatment.Currently,multi-functional MRI technology has demonstrated better prognosis predictive performance than conventional MRI technology,but the value of conventional MRI in clinical applications cannot be ignored due to its higher resolution,better stability and wider availability.In recent years,several studies have investigated the value of the skull base structures invasion(e.g.,skull bone invasion,soft tissue infiltration,etc.)of NPC and other morphological features(e.g.,extra-nodal extension,lymph node necrosis,etc.)of metastatic lymph nodes in predicting the prognosis of NPC,and the addition of certain conventional MRI features to the current eighth edition staging can significantly improve the predictive performance.Therefore,the present study summarizes the value of multi-dimensional primary tumor and lymph node features in conventional MRI[including T2WI,contrast-enhanced T1WI(CE-T1WI),diffusion weighted imaging(DWI)]in the prognosis prediction of NPC to provide a reliable basis for clinical diagnosis and treatment.

关 键 词：磁共振成像 鼻咽癌 预后评估 诱导化疗 淋巴结转移 

分 类 号：R445.2[医药卫生—影像医学与核医学] R739.62[医药卫生—诊断学]