本文選題：鼻咽腫瘤 + 磁共振成像　； 參考：《影像診斷與介入放射學(xué)》2016年03期

【摘要】：目的探討MRI灌注成像對(duì)鼻咽癌放療后局部纖維化與腫瘤復(fù)發(fā)的診斷價(jià)值。方法將放射治療后鼻咽癌局部纖維化(31例)及腫瘤復(fù)發(fā)病例(25例)共56例分為2組,采用FLASH序列進(jìn)行動(dòng)態(tài)增強(qiáng)及灌注成像掃描,獲得動(dòng)態(tài)增強(qiáng)時(shí)間-信號(hào)強(qiáng)度曲線類型,統(tǒng)計(jì)分析動(dòng)態(tài)增強(qiáng)及灌注成像參數(shù):達(dá)峰時(shí)間(TTP)、最大斜率(Slope_(max))、曲線下面積(AUC),并獲取偽彩圖,及進(jìn)行統(tǒng)計(jì)學(xué)處理。結(jié)果放療后復(fù)發(fā)組動(dòng)態(tài)增強(qiáng)時(shí)間-信號(hào)曲線類型均呈速升型,出現(xiàn)明顯上升期,隨后轉(zhuǎn)為平臺(tái)期或緩升緩降期;放療后纖維化組時(shí)間-信號(hào)曲線呈緩升型,出現(xiàn)緩慢上升期,隨后轉(zhuǎn)為平臺(tái)期或緩升緩降期。2組病例MRI動(dòng)態(tài)增強(qiáng)參數(shù)TTP、Slope_(max)、AUC的均值行組間兩兩比較,復(fù)發(fā)組和纖維化組的Slope_(max)、TTP均值存在統(tǒng)計(jì)學(xué)差異,t值分別為67.18、-21.04(P0.05)。灌注參數(shù)偽彩圖可直觀的顯示腫瘤或放療后纖維化組織相應(yīng)的血流灌注情況,發(fā)現(xiàn)AUC灌注偽彩圖顯示腫瘤組織較為清晰,分辨率較好。結(jié)論應(yīng)用MR動(dòng)態(tài)增強(qiáng)及灌注成像有助于鑒別鼻咽癌復(fù)發(fā)和纖維化。
[Abstract]:Objective to evaluate the value of MRI perfusion imaging in diagnosis of local fibrosis and tumor recurrence after radiotherapy in nasopharyngeal carcinoma (NPC). Methods Fifty-six patients with local fibrosis (31 cases) and recurrent cases (25 cases) of nasopharyngeal carcinoma after radiotherapy were divided into two groups. Dynamic contrast enhancement and perfusion imaging were performed with flash sequence to obtain the type of dynamic enhancement time-signal intensity curve. The parameters of dynamic enhancement and perfusion imaging: peak time (TTP), area under Slope _ (max), curve (AUC) were analyzed, and pseudo-color images were obtained and processed statistically. Results the type of dynamic enhancement time-signal curves in patients with recurrence after radiotherapy was rapid ascending, and then changed to platform stage or slowly rising and descending phase, and the time-signal curve of fibrosis group showed slow rising type and slow rising period after radiotherapy. The mean value of TTPN Slope _ (max) was compared between the two groups. There was statistical difference between the recurrent group and the fibrosis group. The difference was 67.18 ~ 21.04 (P0.05). Perfusion parameters pseudochromogram can directly display the blood perfusion of tumor or fibrosis tissue after radiotherapy. It is found that the perfusion pseudochromogram of AUC shows tumor tissue clearly and has good resolution. Conclusion dynamic contrast-enhanced Mr and perfusion imaging are helpful in differentiating recurrence and fibrosis of nasopharyngeal carcinoma.
【作者單位】： 深圳市人民醫(yī)院(暨南大學(xué)第二臨床醫(yī)學(xué)院)放射科;
【基金】：2010年深圳市科技計(jì)劃項(xiàng)目(201002008) 深圳市重點(diǎn)學(xué)科基金資助(297182)
【分類號(hào)】：R445.2;R739.63

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