全身弥散加权成像在鼻咽癌患者诊断中的应用研究

The Clinical Application of Whole-body Diffusion Weighted Imaging of Nasopharyngeal Cancer

  • 摘要: 目的:探讨全身弥散加权成像在鼻咽癌患者中的应用价值。方法:收集中山大学肿瘤防治中心2008年8 月至2009年12月经病理确诊为鼻咽癌患者43例,观察鼻咽原发病灶、转移性病灶、良性淋巴结以及肝脏良性病灶在全身弥散加权图像上的表现并测量其表观弥散系数(Apparent Diffusion Coefficient,ADC )。 结果:鼻咽原发灶、转移性淋巴结、肝转移瘤、骨转移瘤、肺转移瘤在全身弥散加权成像上呈明显高于背景信号病灶,其ADC 值分别为(1.15± 0.21)× 10-3mm/s2、(1.19± 0.24)× 10-3mm/s2、(1.17±0.24)× 10-3mm/s2、(1.13± 0.26)× 10-3mm/2及(1.12± 0.33)× 10-3mm/2,原发病灶与各部位转移灶的ADC 值之间没有统计学差异(P>0.05)。 良性淋巴结和肝脏良性病灶ADC 值分别为(1.37± 0.27)× 10-3mm/2及(2.15± 0.63)× 10-3mm/s2,良性病灶明显高于转移性病灶(P<0.05)。 结论:全身弥散加权成像作为功能性磁共振成像的一项新技术,可以用于鼻咽癌患者的治疗前分期以及治疗后随访。

     

    Abstract: Objective:To evaluate the clinical application of whole-body diffusion weighted imaging of nasopharyngeal cancers (NPCs ).Methods:Clinical data of 43 patients histopathologically confirmed cases of NPC, treated at Cancer Center of Sun Yat-sen Uni-versity from August2008to December 2009, were analyzed. The apparent diffusion coefficient values (ADCs) and the imaging features of the original and metastatic lesions, the negative lymph nodes, and the benign hepatic masses were repeatedly measured and com-pared. Results: In the whole-body diffusion weighted imaging, the primary NPCs and the metastatic lesions were depicted with high signal intensity. The mean ADC values of the primary NPCs, lymph nodes, hepatic, bone, and pulmonary metastasis were ( 1.15± 0.21)× 10-3mm/s2, ( 1.19± 0.24) × 10-3mm/s2, ( 1.17± 0.24) × 10-3mm/s2, ( 1.13± 0.26) × 10-3mm/s2, and ( 1.12± 0.33) × 10-3mm/s2, respectively. There were no significant differences between the primary and metastases lesions or the metastasis between different parts of the body (P > 0.05). The benign lymph node and hepatic masses were depicted with slightly high signals in the DWI; their ADC val -ues were (1.37± 0.27) × 10-3mm/s2 and (2.15± 0.63) × 10-3mm/s2. There were significant differences in mean ADC values between the positive and negative lymph nodes, and between malignant and benign hepatic masses ( P < 0.001 ). The ADC values of the benign lesions were higher than the malignant ones. Conclusion:WB-DWI is a new functional magnetic resonance (MR) technique that can be used for the staging of NPC patients and for detecting tumor metastasis or recurrence.

     

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