| 白 琛,唐 芳,张 志,刘亚斌,胡富碧.动态对比增强磁共振成像在鼻咽癌分期中的应用价值[J].,2019,19(17):3342-3346 |
| 动态对比增强磁共振成像在鼻咽癌分期中的应用价值 |
| Application Value of Dynamic Contrast-enhanced Magnetic Resonance Imaging in Staging of Nasopharyngeal Carcinoma |
| 投稿时间：2019-02-08 修订日期：2019-02-28 |
| DOI：10.13241/j.cnki.pmb.2019.17.030 |
| 中文关键词: 动态对比增强磁共振成像 鼻咽癌 分期 应用价值 |
| 英文关键词: Dynamic contrast-enhanced magnetic resonance imaging Nasopharyngeal carcinoma Stage Application value |
| 基金项目:四川省教育厅科研基金项目（17ZA0136） |
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| 中文摘要: |
| 摘要 目的：分析动态对比增强磁共振成像（DCE-MRI）在鼻咽癌分期中的应用价值。方法：选取2016年6月至2018年4月我院经病理证实的初诊鼻咽癌患者104例为研究对象，均行DCE及扩散加权成像（DWI）检查，比较不同鼻咽癌分期患者的DCE-MRI定量参数[转运常数（Ktrans）、血管外细胞外间隙体积百分数（Ve）、速率常数（Kep）、容积分数（fPV）]及表观扩散系数（ADC）值，分析各DCE-MRI参数与临床分期的相关性，并评估DCE-MRI对鼻咽癌分期的诊断价值。结果：随总分期增加，鼻咽癌患者Ktrans、Ve增加，且Ve随T分期增加而增加，M1分期者Ktrans、Ve大于M0分期者（P＜0.05），不同N分期患者各DCE-MRI参数比较差异无统计学意义（P＞0.05），Kep、fPV在各分期中比较差异也无统计学意义（P＞0.05）；随总分期增加，鼻咽癌患者ADC值减少（P＜0.05）；Spearman相关分析发现，鼻咽癌患者Ktrans与总分期、M分期呈正相关，Ve与总分期、T分期呈正相关，ADC值与总分期呈负相关（P＜0.05）；各参数中，Ktrans诊断鼻咽癌总分期的曲线下面积（AUC）最大，为0.925，Ktrans诊断鼻咽癌早期（Ⅱ期）、晚期（Ⅲ期与Ⅳ期）的AUC分别为0.909、0.921，均较ADC（AUC=0.864、0.815）高。结论：DCE-MRI在鼻咽癌临床分期中有较高应用价值，其中Ktrans的诊断效能最好且高于DWI诊断，肿瘤分期越高，Ktrans越大，可作为肿瘤分期的一个指标。 |
| 英文摘要: |
| ABSTRACT Objective: To analyze the application value of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) in staging of nasopharyngeal carcinoma. Methods: 104 patients with newly diagnosed nasopharyngeal carcinoma confirmed by pathology in our hospital from June 2016 to April 2018 were chosen in the study.All patients were given DCE and diffusion-weighted imaging (DWI),the DCE-MRI quantitative parameters of nasopharyngeal carcinoma patients at different stages[transport constant (Ktrans), extravascular extracellular space volume percentage (Ve), rate constant (Kep), volume fraction (fPV)] and apparent diffusion coefficient (ADC) values were compared, the relationship beween each DCE-MRI parameter and the clinical staging was analyzed, the diagnostic value of DCE-MRI for stage of nasopharyngeal carcinoma was evaluated. Results: With the increase of total stage, Ktrans and Ve increased in patients with nasopharyngeal carcinoma, Ve increased with the increase of T stage. Ktrans and Ve in patients at M1 stage were greater than those at M0 stage (P<0.05). There was no significant difference in every DCE-MRI parameters in patients with different N stages (P>0.05). There was no significant difference in the scores of Kep and fPV among every stages (P>0.05). With the increase of total stage, the ADC value of patients with nasopharyngeal carcinoma decreased (P<0.05); Spearman Correlation analysis found that Ktrans of patients with nasopharyngeal carcinoma was positively correlated with total stage and M stage, Ve was positively correlated with total stage and T stage, the ADC value was negatively correlated with total stage (P<0.05). Among the each parameter, the area under the curve (AUC) of the total stage for the diagnosis of nasopharyngeal carcinoma by Ktrans was the biggest (0.925). The AUC for the diagnosis of nasopharyngeal carcinoma at early (stage II) and late stage (stage III and stage IV) by Ktrans were 0.909 and 0.921, respectively, which were all higher than ADC (AUC=0.864, 0.815). Conclusion: DCE-MRI has a high application value in the clinical stage of nasopharyngeal carcinoma. Ktrans has the best diagnostic efficacy and is superior to DWI diagnosis.The higher the tumor stage, the larger the Ktrans, which can be used as an index of tumor staging. |
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