贵州医科大学学报

2014, v.39;No.171(06) 838-843

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MRI弥散加权成像及动态增强诊断鼻咽癌侵犯斜坡
Application of MRI Diffusion Weighted Imaging and Dynamic Contrast Enhancement in Diagnosing Nasopharyngeal Carcinoma Invading Slope

商观锋;王世黔;夏文刚;
SHANG Guanfeng;WANG Shiqian;XIA Wengang;Department of Medical Imaging,Second Affiliated Hospital of Guiyang Medical University;

摘要(Abstract):

目的:探讨磁共振扩散加权成像(DWI)及MRI动态增强成像(DCE-MRI)在鼻咽癌侵犯斜坡诊断中的应用价值。方法:93例临床确诊的鼻咽癌患者及16例正常志愿者的斜坡MRI分为斜坡正常组、斜坡受侵组和放疗后斜坡改变组,检测各组DWI的表观弥散系数(ADC)值及MRI动态增强参数包括强化百分数(SI%)、强化峰值(PV)、达峰时间(TTP)及TIC曲线类型,评价ADC值及动态增强参数在诊断斜坡受侵中的作用。结果:斜坡受侵组ADC、SI%及PV值高于放疗后斜坡改变组及斜坡正常组,差异有统计学意义(P<0.05),放疗后斜坡改变组TTP值高于斜坡受侵组及斜坡正常组,差异有统计学意义(P<0.05);斜坡正常组以TIC I型曲线为主,放疗后斜坡改变组以I型及III型曲线为主,斜坡受侵组以IV及V型曲线为主;诊断NPC病人斜坡受侵的最佳阈值为ADC值大于0.45×10-3mm2/s,TIC曲线Ⅳ型、V型,强化百分数SI%>121.1,强化峰值(PV)>1 050,达峰时间(TTP)<92.5 s;DWI(ADC值)及MRI动态增强诊断斜坡受侵能力:DCE-MRI敏感性与DWI相差不大,DCE-MRI准确性高于DWI。结论:DWI及DCE-MRI诊断鼻咽癌斜坡受侵均有较高的敏感性和准确性,两者联合检查效果更好。
Objective: To investigate clinical application value of MRI magnetic diffusion weighted imaging( DWI) and MRI dynamic contrast enhancement( DCE-MRI) to diagnose nasopharyngeal carcinoma( NPC) invading slope. Methods: Ninety-three patients with nasopharyngeal carcinoma and 16 healthy volunteers were divided into healthy slope group( group A),slope invasion group( group B)and slope change after radiotherapy group( group C); testing DWI( ADC values) and DCE-MRI parameters( including SI%,PV,TTP and TIC curve); assessing the function of ADC and DCE value in diagnosing slope invasion. Results: ADC,SI% and PV values of group B were higher than group A and group C,differences were statistically significant( P < 0. 05),TTP value of group C was higher than that of group A and group B,differences were statistically significant( P < 0. 05); Group A mainly presented TIC I type curve,group C presented type I and III curve,group B presented type IV and V curve; premium thresholds in diagnosing NPC patients with slope invasion were ADC values > 0. 45 ×10- 3mm2/ s,TIC curve as type IV and V,SI% > 121. 1,PV > 1 050,TTP < 92. 5. DWI( ADC values) and DCE-MRI for diagnosing slope invasion: DCE-MRI sensitivity was equal to DWI,DCE-MRI was more accurate than DWI. Conclusions: DWI and DCE-MRI are more accurate and sensitive in diagnosing nasopharyngeal carcinoma( NPC) invading slope,combined diagnosing will be more effective.

关键词(KeyWords): 癌;鼻咽;斜坡受侵;磁共振成像;图像增强;诊断
cancer;nasopharynx;slope invasion;magnetic resonance imaging;dynamic contrast enhancement;diagnosis

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作者(Author): 商观锋;王世黔;夏文刚;
SHANG Guanfeng;WANG Shiqian;XIA Wengang;Department of Medical Imaging,Second Affiliated Hospital of Guiyang Medical University;

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