中华耳鼻咽喉头颈外科杂志
中華耳鼻嚥喉頭頸外科雜誌
중화이비인후두경외과잡지
Chinese Journal of Otorhinolaryngology Head and Neck Surgery
2015年
9期
754-759
,共6页
鼻咽肿瘤%癌,鳞状细胞%放射疗法,调强适形%涎腺%弥散磁共振成像
鼻嚥腫瘤%癌,鱗狀細胞%放射療法,調彊適形%涎腺%瀰散磁共振成像
비인종류%암,린상세포%방사요법,조강괄형%연선%미산자공진성상
Nasopharyngeal neoplasms%Carcinoma,squamous%Radiotherapy,intensity-modulated%Salivary glands%Diffusion magnetic resonance imaging
目的 应用弥散加权磁共振成像(DWMRI)评价调强放疗(intensity modulated radiotherapy,IMRT)前后鼻咽癌患者唾液腺功能损伤及恢复情况.方法 2009年7月至201 1年1月在山西医科大学第一医院就诊经病理证实的鼻咽癌患者23例,男∶女为19∶4,年龄37 ～ 69岁.所有患者行IMRT治疗,据腮腺受照射剂量分组:低剂量组(＜26 Gy)和高剂量组(≥26 Gy).在IMRT前、结束后1d、结束后6个月及12个月分别行静息及酸刺激(口含维生素C0.5g)下唾液腺DWMRI检查.采用SPSS 13.0统计软件及SAS 8.2统计软件对数据进行统计学分析.结果 两组患者IMRT后6个月与IMRT后1d比较,表观扩散系数(apparent diffusion coefficient,ADC)差异无统计学意义(t值分别为0.732、1.405,P值均＞0.05),IMRT后12个月比IMRT后1d降低,差异有统计学意义(t值分别为2.621、3.417,P值均＜0.05).酸刺激下腮腺ADC值,低剂量组IMRT后各随访时间点差异有统计学意义(P值均＜0.05),高剂量组差异无统计学意义(P值均＞0.05).IMRT后高剂量组酸刺激各时点腮腺平均ADC值均明显高于低剂量组,差异均有统计学意义(P值均＜0.05).静息状态颌下腺ADC值,IMRT后1天、6个月、12个月比IMRT前均升高,差异均有统计学意义(t值分别为-9.782、-8.963、-7.722,P值均＜0.05).酸刺激下颌下腺ADC值,IMRT后各随访时间点差异无统计学意义(F=1.124,P=0.348).结论 ADC值可以反映唾液腺功能的变化情况.DWMRI在观察放疗对唾液腺功能影响及随访期间唾液腺功能恢复方面有一定临床应用价值.
目的 應用瀰散加權磁共振成像(DWMRI)評價調彊放療(intensity modulated radiotherapy,IMRT)前後鼻嚥癌患者唾液腺功能損傷及恢複情況.方法 2009年7月至201 1年1月在山西醫科大學第一醫院就診經病理證實的鼻嚥癌患者23例,男∶女為19∶4,年齡37 ～ 69歲.所有患者行IMRT治療,據腮腺受照射劑量分組:低劑量組(＜26 Gy)和高劑量組(≥26 Gy).在IMRT前、結束後1d、結束後6箇月及12箇月分彆行靜息及痠刺激(口含維生素C0.5g)下唾液腺DWMRI檢查.採用SPSS 13.0統計軟件及SAS 8.2統計軟件對數據進行統計學分析.結果 兩組患者IMRT後6箇月與IMRT後1d比較,錶觀擴散繫數(apparent diffusion coefficient,ADC)差異無統計學意義(t值分彆為0.732、1.405,P值均＞0.05),IMRT後12箇月比IMRT後1d降低,差異有統計學意義(t值分彆為2.621、3.417,P值均＜0.05).痠刺激下腮腺ADC值,低劑量組IMRT後各隨訪時間點差異有統計學意義(P值均＜0.05),高劑量組差異無統計學意義(P值均＞0.05).IMRT後高劑量組痠刺激各時點腮腺平均ADC值均明顯高于低劑量組,差異均有統計學意義(P值均＜0.05).靜息狀態頜下腺ADC值,IMRT後1天、6箇月、12箇月比IMRT前均升高,差異均有統計學意義(t值分彆為-9.782、-8.963、-7.722,P值均＜0.05).痠刺激下頜下腺ADC值,IMRT後各隨訪時間點差異無統計學意義(F=1.124,P=0.348).結論 ADC值可以反映唾液腺功能的變化情況.DWMRI在觀察放療對唾液腺功能影響及隨訪期間唾液腺功能恢複方麵有一定臨床應用價值.
목적 응용미산가권자공진성상(DWMRI)평개조강방료(intensity modulated radiotherapy,IMRT)전후비인암환자타액선공능손상급회복정황.방법 2009년7월지201 1년1월재산서의과대학제일의원취진경병리증실적비인암환자23례,남∶녀위19∶4,년령37 ～ 69세.소유환자행IMRT치료,거시선수조사제량분조:저제량조(＜26 Gy)화고제량조(≥26 Gy).재IMRT전、결속후1d、결속후6개월급12개월분별행정식급산자격(구함유생소C0.5g)하타액선DWMRI검사.채용SPSS 13.0통계연건급SAS 8.2통계연건대수거진행통계학분석.결과 량조환자IMRT후6개월여IMRT후1d비교,표관확산계수(apparent diffusion coefficient,ADC)차이무통계학의의(t치분별위0.732、1.405,P치균＞0.05),IMRT후12개월비IMRT후1d강저,차이유통계학의의(t치분별위2.621、3.417,P치균＜0.05).산자격하시선ADC치,저제량조IMRT후각수방시간점차이유통계학의의(P치균＜0.05),고제량조차이무통계학의의(P치균＞0.05).IMRT후고제량조산자격각시점시선평균ADC치균명현고우저제량조,차이균유통계학의의(P치균＜0.05).정식상태합하선ADC치,IMRT후1천、6개월、12개월비IMRT전균승고,차이균유통계학의의(t치분별위-9.782、-8.963、-7.722,P치균＜0.05).산자격하합하선ADC치,IMRT후각수방시간점차이무통계학의의(F=1.124,P=0.348).결론 ADC치가이반영타액선공능적변화정황.DWMRI재관찰방료대타액선공능영향급수방기간타액선공능회복방면유일정림상응용개치.
Objective To evaluate the dynamic change of salivary gland function in patients with nasopharyngeal carcinoma (NPC) before and after intensity modulated radiotherapy (IMRT) by DWMRI.Methods Twenty-three NPC patients confirmed by pathology were enrolled.Male/Female:19/4.The age was from 37 to 69 years.All cases underwent salivary glands examination by DWMRI before IMRT,at the end of IMRT,6 months and 12 months after IMRT,at the same time the ADC value of salivary glands were calculated.The patients were divided into two groups:G1,Dmean ＜26 Gy,G2,Dmean≥26 Gy.SPSS 13.0 and SAS 8.2 software was used to analyze the date.Results The ADC values of parotid in two group patients at rest were not significantly different between 6 months after and at the end of IMRT (t value was 0.732,1.405,all P ＞ 0.05).The ADC values of parotid in two group patients at rest were significantly lower in the 12 months after IMRT than at the end of IMRT(t value 2.621,3.417,all P ＜0.05).During the period of acid stimulation,A significant change of ADC in parotid was found in G1 (all P ＜ 0.05) and no significant change of ADC in parotid was found in G2 at the various follow-up time after IMRT (all P ＞ 0.05).At the various follow-up time after IMRT,the average ADC values of parotid were significantly higher in G2 than G1 in the same time points of acid stimulation (all P ＜ 0.05).The ADC values of submandibular glands at rest were significantly higher at the various follow-up time after IMRT than before IMRT(t value was-9.782,-8.963,-7.722,all P ＜0.05).During the period of acid stimulation no significant change of ADC in submandibular glands was found after IMRT (F =1.124,P =-0.348).Conclusions The changes of salivary function can be well reflected by ADC values.There is a good clinical application value of DWMRI for evaluating radiation-induced salivary glands functional changes and observing salivary function recovery during the follow-up period after IMRT.
