Isotropic volumetric MRI for displaying cranial perineural spread of cranial nerve in nasopharyngeal carcinoma  

各向同性容积MRI显示鼻咽癌脑神经周围扩散

作　　者：ZHENG Dechun XU Shugui LAI Guojing HU Chunmiao CAO Xisheng FENG Meimei PENG Li 郑德春;许淑桂;赖国静;胡春淼;曹喜生;冯妹妹;彭莉(福建医科大学肿瘤临床医学院、福建省肿瘤医院放射诊断科,福建福州350014;福建医科大学肿瘤临床医学院、福建省肿瘤医院放射治疗中心,福建福州350014)

机构地区：[1]Department of Radiology,Clinical Oncology School of Fujian Medical University,Fujian Cancer Hospital,Fuzhou 350014,China [2]Department of Radiation Oncology,Clinical Oncology School of Fujian Medical University,Fujian Cancer Hospital,Fuzhou 350014,China

出　　处：《中国医学影像技术》2024年第8期1164-1169,共6页Chinese Journal of Medical Imaging Technology

基　　金：福建省自然基金项目(2021J01427)。

摘　　要：Objective To observe the value of isotropic volumetric MRI for displaying perineural spread(PNS)of cranial nerve(CN)in nasopharyngeal carcinoma.Methods Eighty-seven patients with pathologically proven nasopharyngeal carcinoma were prospectively enrolled.MR scanning,including three-dimensional liver acquisition with volume acceleration-flexible(3D LAVA_Flex)image,T2WI with fat suppression(T2WI-FS),T1WI,contrast enhancement(CE)T1WI-FS of nasopharynx and neck region were performed.The displaying rates of CN PNS were evaluated and compared between 3D LAVA_Flex and T2WI-FS,T1WI,CE-T1WI-FS at patient level,CN group level and neural level,respectively.Results The displaying rate of CN PNS in all 87 nasopharyngeal carcinoma patients by 3D LAVA_Flex sequence was 49.43%(43/87),higher than that of conventional MRI(30/87,34.48%,P=0.001).Among 59 patients with advanced nasopharyngeal carcinoma diagnosed with conventional sequences,the displaying rate of CN PNS was 71.19%(42/59)by 3D LAVA-Flex sequence,higher than that of conventional MRI(30/59,50.85%,P=0.001).At both patient level and posterior CN level,significant differences of the displaying rate of CN PNS were found between 3D LAVA-Flex sequence and T2WI-FS,T1WI,CE-T1WI-FS,while at CN level,the displaying rates of mandibular nerve PNS,CNⅨ—ⅪPNS in jugular foramen(P<0.05)and CNⅨ—ⅫPNS in carotid space of 3D LAVA_Flex sequence were all significantly higher than that of T2WI-FS,T1WI and CE-T1WI-FS(all P<0.05),of PNS of CNⅢ—Ⅴin cavernous sinus were higher than that of T2WI-FS(P<0.05),while of PNS of hypoglossal nerve were significantly higher than that of T2WI-FS and T1WI(both P<0.05).Conclusion 3D LAVA_Flex sequence could be used to effectively display CN PNS of nasopharyngeal carcinoma.目的观察各向同性容积MRI显示鼻咽癌脑神经(CN)周围扩散(PNS)的价值。方法前瞻性纳入87例经病理证实的鼻咽癌患者,采集鼻咽及颈部各向同性三维肝脏容积加速采集(3D LAVA_Flex)序列图像、脂肪抑制T2WI(T2WI-FS)、T1WI及增强T1WI-FS,分别于患者水平、CN组水平及单支神经水平比较各序列显示鼻咽癌CN PNS的价值。结果对于鼻咽癌CN PNS,3D LAVA_Flex序列阳性率为49.43%(43/87),高于常规MRI的34.48%(30/87,P=0.001)。在59例常规序列诊断为中晚期鼻咽癌患者中,3D LAVA_Flex序列显示CN PNS的阳性率为71.19%(42/59),常规MRI为50.85%(30/59),前者高于后者(P=0.001);在患者及后组CN水平,3D LAVA_Flex序列与T2WI-FS、T1WI、增强T1WI-FS显示CN PNS阳性率差异均有统计学意义(P均<0.05);而在单支CN水平,3D LAVA_Flex序列显示下颌神经、颈静脉孔CNⅨ~Ⅺ、颈动脉鞘间隙CNⅨ~ⅫPNS的阳性率均高于T2WI-FS、T1WI及增强T1WI-FS(P均<0.05),显示海绵窦CNⅢ~ⅤPNS的阳性率高于T2WI-FS(P<0.05),显示舌下神经PNS阳性率高于T2WI-FS及T1WI(P均<0.05)。结论3D LAVA_Flex序列可较好地显示鼻咽癌CN PNS。

关 键 词：nasopharyngeal neoplasm cranial nerve magnetic resonance imaging neoplasm metastasis prospective studies 

分 类 号：R739.6[医药卫生—肿瘤] R445.2[医药卫生—临床医学]