IVIM与3D pCASL在鼻咽癌临床分期中的对照研究

目的与体素内不相干运动(intravoxel incoherent motion,IVIM)双指数模型对照,探讨三维准连续动脉自旋标记(three-dimensional pseudo continuous arterial spin labeling,3D pCASL)在鼻咽癌临床分期中的应用价值。材料与方法搜集确诊为鼻咽癌的首诊患者36例。所有患者均行鼻咽部MRI平扫加增强、多b值扩散加权序列和三维准连续动脉自旋标记序列扫描,并对患者进行临床分期(中国2008分期),分为高低级别两个组。将原始数据传入GEAW4.6工作站进行后处理,获得D*、D、f及BF_(ASL)图,并测量肿瘤实质区的D*、D、f值及BF_(ASL)值。比较各参数与鼻咽癌各临床分期间的相关性。结果在BF_(ASL)图及D*图像上,高级别组肿瘤表现为明显高灌注,低级别组肿瘤表现为稍高或中低灌注。在总分期、T分期及N分期中,高级别组肿瘤的BF_(ASL)值及D*值显著高于低级别组,f值高于低级别组,D值低于低级别组,均具有统计学意义(P0.05)。BF_(ASL)值、D*值及f值与总分期、T分期及N分期均呈正相关,D值与总分期、T分期及N分期均呈负相关;BF_(ASL)值与D*值、f值具有很好的正相关性。BF_(ASL)、D*、f及D值在各临床分期均有很好的诊断效能,在临床总分期、T分期及N分期中,BF_(ASL)值诊断效能最佳,ROC面积分别约为0.96、0.94、0.97。结论 3D pCASL与IVIM作为一种无创的功能磁共振灌注成像,可以很好地评估鼻咽癌的血流灌注信息,用于预测鼻咽癌治疗前的临床分期,且3D pCASL的诊断效能要高于IVIM。

Comparative study of IVIM and 3D pCASL in the clinical staging of nasopharyngeal carcinoma

Objective: To explore the application value of 3D pCASL (three-dimensional pseudo continuous arterial spin labeling) in the clinical staging of nasopharyngeal carcinoma with IVIM (intravoxel incoherent motion) double exponential model. Materials and Methods: We collected 36 cases of first diagnosed patients with nasopharyngeal carcinoma in our hospital. All patients underwent plain MR scan plus enhancement, multiple B diffusion weighted sequence and three-dimensional pseudo continuous arterial spin labeling sequence, and using Chinese 2008 staging system for staging, which was divided into high and low level group. The original data were sent to GEAW 4.6 workstation for post-processing to get D*, D, f and BFASL images, and the D*, D, f and BFASL values of the tumor parenchyma were measured. To compare the correlation between the parameters and the clinical stage of nasopharyngeal carcinoma. Results: In the BFASL and D* images, the tumors of the advanced group showed significantly high perfusion, while the low grade group showed a slightly higher or lower perfusion. In the total stage, T stage and N stage, the BFASL value and D* value of the advanced group were significantly higher than those of the lower level group, the f value was higher than that of the lower level group, and the D value was lower than that of the lower level group, which had statistical significance (P<0.05). BFASL value, D*value and f value were positively correlated with the total stage, T stage and N stage, D value was negatively correlated with the total stage, T stage and N stage. BFASL valueand D* value, f value has a good positive correlation. BFASL, D*, f and D values in each clinical stage have good diagnostic efficacy, in the clinical stage, T stage and N stage, the BFASL value is the best, the ROC area is about 0.96, 0.94, 0.97. Conclusions: 3D pCASL and IVIM imaging both are noninvasive functional magnetic resonance perfusion. They can be a good evaluation of nasopharyngeal carcinoma, and predict clinical staging before treatment of nasopharyngeal carcinoma. The diagnostic efficacy of 3D pCASL was higher than that of IVIM.