CAJ | 학술논문

目的探讨MRI增强扫描在鼻咽癌根治性放疗前后判断疗效中的应用价值，并用体视觉分区分析法追踪观察鼻咽癌分期是否对放疗具有敏感性。材料与方法回顾性分析经病理检查证实的50例初诊鼻咽癌患者，其中9例侵犯咽旁间隙或/和口咽(T2)，29例侵犯颅底或/和翼内肌(T3)，12例侵犯颅神经或/和海绵窦或/和鼻窦或/和翼外肌(T4)，均行近期放射治疗(1疗程30次，66～70 Gy/次，5次/周，共6周)，前后均行T1WI、T2WI和MRI增强扫描，利用体视觉分区分析法对病灶形态、范围及周围组织侵犯变化情况进行测量对比。上述数据均使用独立样本t检验进行统计学分析。结果与放疗前对比，MRI增强扫描，9例侵犯咽旁间隙或/和口咽，29例侵犯颅底或/和翼内肌，7例侵犯颅神经或/和海绵窦或/和鼻窦或/和翼外肌的肿瘤病灶明显缩小及颈部淋巴结退小，并强化不明显或无强化趋势(P＜0.05)。但5例病理分期为T4肿瘤中4例大小变化不明显及1例增大(P＜0.05)，并且病灶标准化强化强度变化也不明显。结论 MRI增强扫描灵敏显示鼻咽癌放疗前后的变化，对鼻咽癌的疗效评价具有很好的临床应用价值。另外，鼻咽癌放疗疗效与病理分期相关。
목적탐토MRI증강소묘재비인암근치성방료전후판단료효중적응용개치，병용체시각분구분석법추종관찰비인암분기시부대방료구유민감성。재료여방법회고성분석경병리검사증실적50례초진비인암환자，기중9례침범인방간극혹/화구인(T2)，29례침범로저혹/화익내기(T3)，12례침범로신경혹/화해면두혹/화비두혹/화익외기(T4)，균행근기방사치료(1료정30차，66～70 Gy/차，5차/주，공6주)，전후균행T1WI、T2WI화MRI증강소묘，이용체시각분구분석법대병조형태、범위급주위조직침범변화정황진행측량대비。상술수거균사용독립양본t검험진행통계학분석。결과여방료전대비，MRI증강소묘，9례침범인방간극혹/화구인，29례침범로저혹/화익내기，7례침범로신경혹/화해면두혹/화비두혹/화익외기적종류병조명현축소급경부림파결퇴소，병강화불명현혹무강화추세(P＜0.05)。단5례병리분기위T4종류중4례대소변화불명현급1례증대(P＜0.05)，병차병조표준화강화강도변화야불명현。결론 MRI증강소묘령민현시비인암방료전후적변화，대비인암적료효평개구유흔호적림상응용개치。령외，비인암방료료효여병리분기상관。
Objective:To investigate the value of using contrast-enhanced magnetic resonance imaging (MRI) for efifcient evaluation before and after radical radiotherapy for nasopharyngeal cancer, and to assess whether the use of visual partitioning analysis for tracking and observing nasopharyngeal cancer staging is sensitive to radiotherapy. Materials and Methods:In total, 50 patients who were preliminarily diagnosed with nasopharyngeal cancer through pathological examinations were retrospectively analyzed, including 9 cases with stage T2, 29 cases with T3, and 12 cases with T4. All cases underwent short-term radiotherapy; T1 weighted imaging, T2 weighted imaging, and contrast-enhanced MRI were performed before and after radiotherapy. visual partitioning analysis was used to comparatively measure the variation in morphology and range of foci, as well as the involvement of surrounding tissues. All the above mentioned data were statistically analyzed using independent samplet-tests. Results:Compared to the conditions before radiotherapy, the tumor foci of 9 cases with parapharyngeal space and/or oropharynx involvement, 29 cases with skull base and/or medial pterygoid involvement, and 7 cases with cranial nerve and/or cavernous sinus and/or paranasal sinus and/or lateral pterygoid involvement showed signiifcant shrinkage or reduction in the size of their cervical lymph nodes, along with non-apparent enhancement or no trend in enhancement (P<0.05). However, among 5 T4 cases, the tumor size non-signiifcantly changed in 4 cases and increased in 1 case (P<0.05); moreover, the intensities of the standardized enhancement of foci did not signiifcantly change.Conclusion:The changes in nasopharyngeal cancer before and after radiotherapy can be sensitively determined through contrast-enhanced MRI,which may thus have good clinical applicability in the effective evaluation of nasopharyngeal cancer. Moreover, the efifcacy of radiotherapy fornasopharyngeal cancer may be associated with the pathological staging.