本文選題：磁共振成像 + 擴(kuò)散加權(quán)成像　； 參考：《安徽醫(yī)科大學(xué)》2012年碩士論文

【摘要】：目的：探討磁共振擴(kuò)散加權(quán)成像(DWI)在鼻咽癌(NPC)放療后隨訪復(fù)查中的臨床應(yīng)用價(jià)值。 方法：經(jīng)臨床和病理證實(shí)的83例鼻咽癌放療后復(fù)查的患者，放療后6個(gè)月以內(nèi)的分為腫瘤殘留和無(wú)殘留組，6個(gè)月以上的分復(fù)發(fā)組和無(wú)復(fù)發(fā)組，行鼻咽部常規(guī)MRI及DWI檢查，詳細(xì)分析他們的MRI資料，并對(duì)鼻咽局部殘存腫塊和（或）鼻咽壁增厚、骨質(zhì)破壞缺損處及兩側(cè)翼外肌進(jìn)行表觀擴(kuò)散系數(shù)（ADC）測(cè)量。 結(jié)果： 1.鼻咽癌放療后無(wú)殘留組33例，其中鼻咽腔正常10例，鼻咽腔變形25例，鼻咽壁增厚28例，鼻咽部/或咽旁殘留腫塊17例，咽旁間隙變窄/消失17例，顱底殘留破壞缺損6例，蝶骨翼板破壞2例，其中鼻咽壁增厚及鼻咽部/或咽旁殘留腫塊ADC值(1.843±0.133)×10~(-3)mm~2/s。 2.殘留組4例，鼻咽壁增厚2例，鼻咽部/或咽旁殘留腫塊2例，咽旁間隙變窄/消失2例，蝶骨體骨質(zhì)破壞1例，，斜坡骨質(zhì)破壞1例，其ADC均值(1.097±0.183)×10~(-3)mm~2/s。 3.無(wú)復(fù)發(fā)組41例，鼻咽腔正常12例，鼻咽腔變形29例，鼻咽壁增厚31例，鼻咽部/或咽旁殘留腫塊25例，咽旁間隙變窄/消失21例，顱底破壞缺損2例，其中鼻咽壁增厚及鼻咽部和（或）咽旁殘留腫塊ADC值（1.884±0.134）×10~(-3)mm~2/s。 4.復(fù)發(fā)組5例，鼻咽壁增厚5例，鼻咽部/或咽旁殘留腫塊5例，顱底骨質(zhì)破壞3例，蝶骨體骨質(zhì)破壞1例，咽旁間隙變窄/消失5例，其ADC均值（0.787±0.067）×10~(-3)mm~2/s。經(jīng)統(tǒng)計(jì)學(xué)處理，殘留組和復(fù)發(fā)組ADC值明顯低于翼外肌ADC值，無(wú)殘留組和無(wú)復(fù)發(fā)組ADC值明顯高于翼外肌ADC值，其差異均有統(tǒng)計(jì)學(xué)意義（P＜0.05）。 結(jié)論：MRI能夠很好的顯示鼻咽癌放療后的改變，尤其在DWI方面，能提供細(xì)胞水平的定性和定量信息，通過(guò)對(duì)興趣區(qū)ADC值的測(cè)量，可敏感而準(zhǔn)確地鑒別鼻咽癌放療后殘留、纖維化斑塊和腫瘤復(fù)發(fā)。
[Abstract]:Objective: to evaluate the clinical value of diffusion weighted Mr imaging (DWI) in the follow-up of patients with nasopharyngeal carcinoma (NPC) after radiotherapy. Methods: 83 patients with nasopharyngeal carcinoma confirmed by clinical and pathological examination after radiotherapy were divided into two groups within 6 months after radiotherapy. The patients who were more than 6 months old were divided into recurrence group and non-recurrence group. Routine nasopharynx MRI and DWI were performed. Their MRI data were analyzed in detail, and the apparent diffusion coefficient was measured at the site of local mass and / or thickening of nasopharynx wall, bone destruction defect and bilateral lateral pterygoid muscles. Results: 1. There were 33 cases of nasopharyngeal carcinoma without residual after radiotherapy, including 10 cases of normal nasopharyngeal cavity, 25 cases of nasopharyngeal cavity deformation, 28 cases of nasopharyngeal wall thickening, 17 cases of residual nasopharynx / or parapharyngeal mass, 17 cases of narrowing / disappearance of parapharyngeal space, 6 cases of skull base residual destruction and defect. Sphenoid wing plate was destroyed in 2 cases. The ADC value of nasopharynx wall thickening and residual nasopharynx / parapharyngeal mass was 1.843 鹵0.133) 脳 10 ~ (-3) mm ~ (-1) / s. 2. In the residual group, there were 2 cases of nasopharyngeal wall thickening, 2 cases of nasopharynx / parapharyngeal residual mass, 2 cases of narrowing / disappearance of parapharyngeal space, 1 case of sphenoid bone destruction and 1 case of Clivus bone destruction. The ADC mean value was 1.097 鹵0.183) 脳 10 ~ (-3) mm ~ (-3) / s. 3. There were 41 cases in no recurrence group, 12 cases normal nasopharyngeal cavity, 29 cases nasopharyngeal cavity deformation, 31 cases nasopharynx wall thickening, 25 cases nasopharyngeal / parapharyngeal residual mass, 21 cases parapharyngeal space narrowing / disappearance, 2 cases skull base damage and defect. The ADC value of nasopharyngeal wall thickening and residual masses in nasopharynx and / or parapharyngeal region was 1.884 鹵0.134 脳 10 ~ (-3) mm ~ (-1) / s. 4. In the recurrent group, there were 5 cases of nasopharyngeal wall thickening, 5 cases of nasopharyngeal / parapharyngeal residual mass, 3 cases of skull base bone destruction, 1 case of sphenoid bone destruction, and 5 cases of parapharyngeal space narrowing / disappearance. The ADC mean value was 0.787 鹵0.067) 脳 10 ~ (-3) mm ~ (-3) / s. The ADC value of the residual group and the recurrent group was significantly lower than the ADC value of the lateral pterygoid muscle, and the ADC value of the non-residual group and the non-recurrent group was significantly higher than that of the ADC value of the lateral pterygoid muscle, and the difference was statistically significant (P < 0.05). Conclusion the changes of nasopharyngeal carcinoma after radiotherapy can be well demonstrated by Mr imaging, especially in DWI, which can provide qualitative and quantitative information of cell level. By measuring the ADC value of the region of interest, it can be sensitive and accurate to distinguish the residual after radiotherapy for nasopharyngeal carcinoma. Fibrosis plaques and tumor recurrence.
【學(xué)位授予單位】：安徽醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2012
【分類號(hào)】：R739.63

【引證文獻(xiàn)】

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1 殷悅;MRI對(duì)鼻咽癌淋巴結(jié)轉(zhuǎn)移及放療評(píng)價(jià)的應(yīng)用研究[D];吉林大學(xué);2013年

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