磁共振表观扩散系数值在鼻咽癌颅底病变放疗前的研究价值

摘要

Objective: To study the appli cation value of the MRI apparent diffusion coefficients in the basicranial bone invasion before radiotherapy of nasopharyngeal carcinoma (NPC). Methods: A retrospective analysis was done of the nasopharyngeal carcinoma patients who had undergone primary radiotherapy but with basicranial invasion since May 2008 in our hospital. Among these patients, 24 cases of recurrence or metastasis and recurrence were chosen to serve as the re-currence group, and 24 cases of no recurrence or metastasis served as the control group. The apparent diffusion coefficients (ADC) of the cranial bases of both groups were measured by diffusion weighted imaging before the therapy, and were ana-lyzed by using SPSS13.0 statistical software for t test, and the clinical value of ADCs in the recurrence and metastasis of nasopharyngeal carcinoma (NPC) on the cranial bases. Results: The mean ADCs of the basicranial lesions before radiother-apy in the two groups were(0.804±0.031)×10-3mm2·s-1 and(0.813±0.035)×10-3mm2·s-1, t=1.60, (P>0.05), respectively, show-ing no significant statistical difference between the two groups. And the difference in the mean ADCs of the basicranial le-sions in the T3 and T4 periods between the two groups was of no statistical significance(P>0.05). Conclusion: ADCs com-bined with the conventional sequences can play a more accurate role in the diagnosis of basicranial invasion of nasopha-ryngeal carcinoma patients, but the ADCs of the basicranial lesions measured before radiotherapy cannot be used as a judg-ment indicator of probable recurrence or metastasis of nasopharyngeal carcinoma (NPC).%目的：探讨磁共振表观弥散系数(ADC)值在鼻咽癌颅底骨质侵犯放射治疗前的应用价值。方法：选择初次鼻咽癌颅底侵犯放疗后有复发或转移24例为复发组，无复发转移24例作对照组，对两组病例在弥散加权成像上测量其放疗前颅底ADC值进行t检验，研究ADC值在鼻咽癌颅底复发和转移中的临床价值。结果：放疗前患者颅底病灶ADC均值复发组为（0.804±0.031）×10-3mm2·s-1，对照组为（0.813±0.035）×10-3mm2·s-1，两组间差异无统计学意义（t=1.60，P>0.05）。且T3、T4期颅底病灶ADC均值比较，两组间差异无统计学意义（P>0.05）。结论：ADC值结合常规序列可更准确地诊断鼻咽癌颅底的侵犯情况，而在放射治疗前测出的颅底病灶ADC值，不能作为判断鼻咽癌颅底病灶是否会复发或转移指标。