鼻咽癌患者磁共振灌注成像参数与T分期及预后的相关性分析  

Correlation Analysis of Magnetic Resonance Perfusion Imaging Parameters,T Staging,and Prognosis in Patients with Nasopharyngeal Carcinoma

作　　者：赵冉 许建华 ZHAO Ran;XU Jian-hua(Department of Otolaryngology,Chongqing Medical University Yubei District Hospital,Yubei 401120,Chong Qing,China)

机构地区：[1]重庆医科大学附属渝北医院耳鼻咽喉科,重庆渝北401120

出　　处：《中国CT和MRI杂志》2024年第9期38-40,共3页Chinese Journal of CT and MRI

摘　　要：目的分析鼻咽癌(NPC)患者灌注加权成像(PWI)参数与T分期及预后的相关性。方法回顾性选取2019年1月至2020年12月我院收治的58例鼻咽癌患者的临床资料,根据检查结果分为低分期组(26例)和高分期组(32例)。比较两组患者基线资料、PWI参数及预后,使用Pearson法分析PWI参数与T分期的相关性;使用多因素logistic回归分析导致NPC患者预后不良的危险因素;绘制受试者工作特征曲线(ROC),以曲线下面积(AUC)评价PWI参数的预测效能。结果本研究58例NPC患者中T1期为11例,T2期为15例,T3期为23例,T4期为9例。低分期组血管外细胞外间隙(EES)的转运常数(Ktrans)值、对比剂从EES流向血浆的速率常数(Kep)值大于高分期组(P<0.05);两组患者容积和血浆容积分数比较,差异无统计学意义(P>0.05)。经Pearson法分析结果显示,NPC患者T分期与Ktrans、Kep均呈明显负相关(P<0.05)。低分期组存活率为88.46%,高分期组存活率为43.75%,低分期组存活率明显优于高分期组(P<0.05)。logistic回归分析结果显示Ktrans、Kep减小为导致NPC患者预后不良的危险因素(P<0.05)。经ROC分析显示,Ktrans和Kep预测NPC患者预后不良的AUC分别为0.745、0.892,联合预测因子AUC为0.912,显著高于单独指标(Z=3.585、8.786,P≤0.001、<0.001),敏感度为100.00%,特异度为73.08%。结论磁共振PWI参数可用于评估NPC患者T分期及预后,Ktrans、Kep与患者T分期呈明显负相关,可作为预后评估的检测指标,且联合检测可提高预测效能。Objective To analyze the correlation of perfusion weighted imaging(PWI)parameters,T staging,and prognosis in patients with nasopharyngeal carcinoma(NPC).Methods The clinical data of 58 patients with NPC admitted to the hospital from January 2019 to December 2020 were analyzed retrospectively.According to examination results,the patients were divided into a low stage group(26 cases)and a high stage group(32 cases).Baseline data,PWI parameters,and prognosis of the two groups were comparatively analyzed.Pearson method was used to analyze the correlation between PWI parameters and T stage.Multivariate logistic regression analysis was conducted to identify the risk factors for poor prognosis of NPC.The predictive performance of PWI parameters was evaluated using the receiver operating characteristic(ROC)curves.Results Among the 58 cases of NPC enrolled in this study,there were 11 cases in T1 stage,15 cases in T2 stage,23 cases in T3 stage,and 9 cases in T4 stage.The transfer coefficient(Ktrans)of extravascular extracellular space(EES)and rate constant(Kep)of contrast agent flowing from EES to plasma in the low stage group were higher than those in the high stage group(P<0.05).There was no statistically significant difference in volume or plasma volume fraction between the two groups(P>0.05).Pearson correlation analysis found that T stage was negatively correlated with Ktrans and Kep in patients with NPC(P<0.05).The survival rate of the low stage group(88.46%)was significantly higher than that of the high stage group(43.75%)(P<0.05).Logistic regression analysis results showed that decreased Ktrans and Kep were risk factors for poor prognosis of NPC(P<0.05).ROC curve analysis showed that the AUC values of Ktrans and Kep for predicting poor prognosis of NPC were 0.745 and 0.892.The AUC of joint prediction with the two was 0.912,significantly higher than that of prediction with a single indicator(Z=3.585,8.786,P≤0.001,<0.001).The sensitivity and specificity were 100.00%and 73.08%.Conclusion PWI parameters can be used to

关 键 词：鼻咽癌 灌注加权成像参数 T分期 预后 相关性 

分 类 号：R766.3[医药卫生—耳鼻咽喉科]