三维准连续式动脉自旋标记与扩散加权成像在鉴别T1期鼻咽癌及淋巴组织增生的对照研究  

Comparative study of three-dimensional pseudo-continuous arterial spin labeling and diffusion weighted imaging in the differential diagnosis of stage T1 nasopharyngeal carcinoma and lymphoid hyperplasia

作　　者：周文娟 莫志英 ZHOU Wenjuan;MO Zhiying(Department of Radiology,Wuzhou People’s Hospital,Wuzhou 543000,China)

机构地区：[1]梧州市人民医院放射科,广西梧州543000

出　　处：《实用放射学杂志》2025年第3期385-389,共5页Journal of Practical Radiology

基　　金：广西壮族自治区卫生健康委员会自筹经费科研项目(Z-D20231649)。

摘　　要：目的 探讨三维准连续式动脉自旋标记(3D pCASL)与扩散加权成像(DWI)鉴别诊断T1期鼻咽癌(NPCT1)及淋巴组织增生(LH)的价值.方法 选取经病理确诊及临床分期为NPCT1 的患者21例(NPCT1 组),经病理确诊为LH的患者50例(LH组).所有患者均在治疗前接受鼻咽部3D pCASL及DWI扫描,测量所有病灶的血流量(BF)值[BF最小值(BF_(min))、BF平均值(BF_(mean))、BF最大值(BF_(max))],病灶与同层面翼外肌BF比值的相对血流量(rBF)值[rBF最小值(rBF_(min))、rBF平均值(rBF_(mean))、rBF最大值(rBF_(max))],表观扩散系数(ADC)值[ADC最小值(ADC_(min))、ADC平均值(ADC_(mean))、ADC最大值(ADC_(max))].分析NPCT1 组与LH组间各参数有无显著差异;受试者工作特征(ROC)曲线分析各参数的诊断效能.结果 相较于LH组,NPCT1 组的BF_(mean)、BF_(max)、rBF_(min)、rBF_(mean)、rBF_(max)值更高,差异有统计学意义(P<0.05);而ADC_(min)、ADC_(mean)、ADC_(max)值在2组间差异无统计学意义(P>0.05).BF_(mean)、BF_(max)、rBF_(min)、rBF_(mean)及rBF_(max)值鉴别诊断NPCT1 和LH的曲线下面积(AUC)分别为0.677、0.804、0.748、0.746及0.858.结论 3D pCASL技术能够无创性反映NPCT1 与LH 的血流灌注差异,可作为一种鉴别两者的有效方法,其中BF_(max)及rBF_(max)具有较好的诊断效能;而DWI难以区分NPCT1 和LH之间在水分子扩散方面的差别,对鉴别诊断价值有限.Objective To explore the value of three-dimensional pseudo-continuous arterial spin labeling(3D pCASL)and diffusion weighted imaging(DWI)in the differential diagnosis of stage T1 nasopharyngeal carcinoma(NPCT1)and lymphoid hyperplasia(LH).Methods A total of 21 patients with pathological diagnosis and clinical stage of NPCT1(NPCT1 group)and 50 patients with pathological diagnosis of LH(LH group)were selected.All patients underwent nasopharyngeal 3D pCASL and DWI scans before treatment.The blood flow(BF)values of all lesions[minimum BF(BF_(min)),mean BF(BF_(mean)),maximum BF(BF_(max))],and the relative blood flow(rBF)values of the ratio of lesions to lateral pterygoid muscle at the same plane[minimum rBF(rBF_(min)),_(mean) rBF(rBF_(mean)),maximum rBF(rBF_(max))],the apparent diffusion coefficient(ADC)values[minimum ADC(ADC_(min)),mean ADC(ADC_(mean)),maximum ADC(ADC_(max))]of all lesions were measured.The differences in parameters between NPCT1 group and LH group were analyzed,and the diagnostic efficiency of each parameter was analyzed via receiver operating characteristic(ROC)curve.Results The values of BF_(mean),BF_(max),rBF_(min),rBF_(mean) and rBF_(max) of NPCT1 group were higher than those of LH group,with statistically significant difference(P<0.05).However,there were no significant difference in the values of ADC_(min),ADC_(mean) and ADC_(max) between the two groups(P>0.05).The area under the curve(AUC)of BF_(mean),BF_(max),rBF_(min),rBF_(mean) and rBF_(max) values for differential diagnosis of NPCT1 and LH were 0.677,0.804,0.748,0.746 and 0.858,respectively.Conclusion 3D pCASL technique can reflect non-invasively the difference of blood perfusion between NPCT1 and LH,and can be used as an effective method to distinguish NPCT1 from LH,with the better diagnostic efficiency of BF_(max) and rBF_(max).However,DWI is difficult to distinguish the difference of water molecule diffusion between NPCT1 and LH,which has limited value in differential diagnosis.

关 键 词：三维准连续式动脉自旋标记 扩散加权成像 鼻咽癌 淋巴组织增生 

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] R739.63[医药卫生—临床医学] R551.2