节点文献
MRI对鼻咽癌放疗后改变的影像价值研究
The Initial Study of Imaging Value on MRI in Nasopharyngeal Carcinoma after Radiotherapy
【作者】 张越；
【导师】 刘艳；
【作者基本信息】 新疆医科大学 ， 影像医学与核医学， 2010， 硕士
【摘要】 目的:探讨磁共振成像对鼻咽癌放射治疗后改变的影像诊断价值,尤其是放疗后复发的诊断及鉴别诊断。方法:收集新疆肿瘤医院2006年1月-2009年10月经病理证实的鼻咽癌病例67例,其中39例行弥散加权像(DWI)扫描。所有病例均行放射治疗、有完整MR复查资料,分析其放疗后不同情况下的MRI表现,及MRI对复发或残留的检出,并进一步利用弥散加权像测定的ADC值来研究放疗后复发与纤维化及残留的鉴别。结果:①MRI基本能反应放疗后咽壁不同变化情况;②MR最初对复发或残留的检出,敏感性85.00%,特异性91.49%,准确性89.55%;③放疗后鼻咽纤维化者ADC值较复发者及残留者明显高(P<0.05),而复发者咽后淋巴结ADC值较纤维化者及残留者明显低(P<0.05)。结论:MRI能清晰地显示鼻咽癌放疗后变化情况,并且对复发的检出准确性较高,放疗后纤维化、残留及复发者ADC值的不同或许为鉴别诊断提供一定参考价值,MRI对放射治疗鼻咽癌的效果评价至关重要。
【Abstract】 Objective: To analyze Magnetic Resonance Imaging (MRI) features and value of naso- pharyngeal carcinoma (NPC) after radiotherapy, and to investigate the values of MRI in differential diagnosis between local recur in post radiotherapy and local radio- fibrosis. Methods: MR scans of 67 patients with proven histological nasopharyngeal carcinoma who were treated mainly with radiation therapy in our hospital from Jan 2006 to Oct 2009 with intact imaging files were analyzed, 39 of 67 patients were scanned with DWI. The tumors’response to the radiation therapy on the follow-up scans was analyzed. And MRI in the differential diagnosis of local recurrence and post radiation fibrosis and residue in NPC was evaluated. Results:①MRI could reflect the shifts of nasopharynx after radio- therapy;②The sensitivity, specificity and accuracy of MRI evaluation in the diagnosis of residue or local recurrence of NPC after radiotherapy, were 85.00%, 91.49%, 89.55%;③The mean apparent diffusion coefficient(ADC) values of NPC in fibrosis after radio- therapy were higher than in local recurrences or residues, but the mean ADC values of retropharyngeal lymph nodes were lower in recurrences of NPC. Conclusion: MRI possesses the obvious advantages in nasopharyngeal carcinoma post-radiotherapy follow up. The accuracy of MRI image evaluation in the diagnosis of recurrence or residue of NPC after radiotherapy is relatively higher. The ADC value may be helpful for the differential diagnosis of post- radiotherapy local recur patients and local fibrosis patients in NPC.