摘要
目的探讨3.0 T MR扩散加权成像(DWI)在评估鼻咽癌(NPC)放化疗(CRT)疗效中的价值,预测NPC对CRT的敏感性。方法收集32例经病理证实的NPC病人,行常规MRI及DWI检查,测量CRT前与CRT5周时NPC及转移性淋巴结最大者的体积和ADC值。以CRT后1个月病理活检和MRI检查作为疗效评价标准将NPC分为低敏感与高敏感组,比较CRT 5周时NPC低敏感组与高敏感组ADC值、治疗前后ADC值变化率(ΔADC)及体积消退率(ΔV)的差异;分析影响NPC CRT敏感性的相关因素。结果CRT 5周时NPC ADC值、ΔADC及ΔV在高、低敏感组之间差异均有统计学意义(P<0.05),ΔADC为鉴别低敏感与高敏感组最佳指标,其截断值为98.125%,敏感度为95.5%,特异度为90%。非线性Logistic回归分析影响NPC CRT敏感性的相关因素(性别、年龄、治疗方式、T分期及ΔADC),结果显示ΔADC是影响NPC CRT敏感程度的独立预后因素,其相对风险度为1.155。结论 DWI对于评价NPC CRT疗效有重要作用。CRT 5周时NPC ADC值、ΔADC及ΔV都能有效预测NPC CRT敏感性,ΔADC是预测NPC CRT敏感性的最佳指标及独立预后因素。
Objebtive To investigate the value of diffusion-weighted 3.0 T MR imaging （DW-MRI） for evaluating therapeutic effect of chemoradiotherapy （CRT） and predicting sensitivity of CRT in nasopharyngeal carcinoma （NPC）. Methods Thirty-two cases with NPC confirmed by pathological biopsy underwent conventional MRI and DWI. We measured the apparent diffusion coefficient （ADC） values before and 5 weeks after CRT. At the same time, the volume of NPC primary tumors and metastatic lymph nodes were measured. Thirty-two cases were grouped into hypersensitivity and hyposensitivity groups based on pathologicaly and MRI findings after a month of therapy. The ADC values, change rate of ADC values （△ADC）, and volume of faded rate （△V） during the 5 weeks were compared between the hypersensitivity and hyposensitivity groups. Logistic regression analysis was used to determine sensitive factors for in NPC chemoradiotherapy. Results The ADC, △ADC and △V value of NPC were statistically difference between hypersensitivity and hyposensitivity groups （P〈0.05） at 5 weeks afer CRT. The △ADC was the best measure to discriminate the two groups （cutoff 98.125%, sensitivity, 95.5%, specificity,90%）. Nonlinear Logistic regression analysis including sex, age, treatment, T stage, and △ADC showed that △ADC was dependent variable for effecting CRT sensitivity of NPC （ relative risk,1.155）. Conclusion DWI has an important role in evaluating therapeutic effect of CRT in NPC. The ADC value, △ADC, and △V of NPC at 5 weeks after CRT could predict the CRT sensitivity. The △ADC is the best indicator in predicting CRT sensitivity, and is a dependent variable for effecting CRT sensitivity in NPC.
出处
《国际医学放射学杂志》
2016年第1期1-5,共5页
International Journal of Medical Radiology
关键词
鼻咽癌
扩散加权成像
表观扩散系数
放化疗
敏感性
Nasopharyngeal carcinoma
Diffusion-weighted imaging
Apparent diffusion coefficient
Chemoradiotherapy
Sensitivity
