MR涎管成像对鼻咽癌放疗患者涎腺功能

目的 探究MR涎管成像用于评价鼻咽癌调强放疗患者涎腺功能的可行性。方法在放疗前、放疗结束时分别采集32例鼻咽癌患者腮腺和下颌下腺在静息及酸刺激下MR涎管成像图像,同时对涎管可见性及放射性口干进行评价,Spearman相关分析用于急性放射性口干评级与MR涎管成像评分关系的研究。结果 放疗后涎腺导管可见性、MR涎管成像评分均较放疗前降低(P=0.000、0.000)。非重度口干与重度口干相比,腮腺导管静息与刺激下MR涎管成像评分差值不同(P=0.009),下颌下腺导管静息与刺激下MR涎管成像评分差值也不同(P=0.005);腮腺导管静息与刺激下,以及下颌下腺导管静息与刺激下得分均相近(P=0.881、0.305、0.327、0.229)。Spearman相关分析显示急性口干与腮腺导管静息与刺激得分差值,以及下颌下腺导管静息与刺激得分差值均呈负相关(R=－0.472,P=0.006;R=－0.482,P=0.005)。结论 MR涎管成像评分与口干具有相关性,MR涎管成像可用于评价鼻咽癌放疗患者的涎腺功能。

Value of magnetic resonance sialography in evaluation of salivary gland function in patients with nasopharyngeal carcinoma treated with radiotherapy

Objective To investigate the feasibility of magnetic resonance sialography (MRS) in the evaluation of salivary gland function in patients with nasopharyngeal carcinoma treated with intensity-modulated radiotherapy. Methods The MRS images of parotid and submandibular glands were collected in resting and stimulated states among 32 patients with nasopharyngeal carcinoma before and after radiotherapy. The visibility of the salivary ducts and radiation-induced xerostomia were evaluated, and the relationship between radiation-induced acute xerostomia grade and MRS score was analyzed. Comparison of the visibility and score between two groups was made by paired t test, and the correlation between acute xerostomia grade and MRS score was determined using the Spearman rank correlation method. Results Both the visibility of salivary duct and MRS score were significantly reduced after radiotherapy (P=0.000,P=0.000). There were significant differences in the variation of MRS scores of the parotid (DPS) and submandibular glands (DSS) from the resting state to the stimulated state between patients with severe and non-severe acute xerostomia (P=0.009;P=0.005). There were no significant differences in MRS scores of the parotid and submandibular glands in resting and stimulated states between patients with severe and non-severe acute xerostomia (P=0.881, P=0.305, P=0.327, P=0.229). The Spearman correlation analysis showed that the acute xerostomia grade was negatively correlated with DPS and DSS (R=－0.472, P=0.006;R=－0.482, P=0.005). Conclusions MRS score is correlated with xerostomia grade. MRS can be used to evaluate the salivary gland function in patients with nasopharyngeal carcinoma treated with radiotherapy.