鼻咽癌放射治疗后MRI检查的价值

目的 探讨MRI对鼻咽癌(NPC)放射治疗后的临床价值.方法 109例NPC患者在放疗前、放疗中及放疗后多次行MRI检查,对比分析治疗前后MRI表现的异同,以此评价NPC的放疗效果.所有病例均经病理活检或针吸细胞学检查或随访追踪证实.结果 所有病例中,放疗前44例已发生颅底骨质侵犯;放疗开始1～2周可在放疗局部出现水肿,放疗后1个月局部水肿逐渐消退.65例病灶放疗后逐渐变小至完全消失;27例病灶在放疗过程中逐渐缩小,但放疗后6个月复查MRI示肿块又明显增大,其中12例出现颅底骨质破坏;17例放疗后病灶先是逐渐缩小,后多次复查MRI发现病灶呈团块状改变且形态相对固定,病理证实为纤维化;9例半年后复查MRI发现放射性脑损伤.结论 MRI检查可准确反应NPC放射治疗前后病灶变化情况,定期随访复查对于及时调整治疗方案具有重要参考价值.Abstract：Objective To explore the clinical values of MRI after radiotherapy for nasopharyngeal carcinoma(NPC). Methods One hundred and nine patients with NPC comfirmed by pathological biopsy or cytological smear or follow-up underwent MRI studies before,in the period of and after radiotherapy,and made a comparative analysis about differences of MRI manifestations before and after treatment, to evaluate radiotherapy effect for NPC depending on different appearances of MRI. Results Among all patients, there appeared to show violation of skull base bone in 44 patients before radiotherapy.Local edema appeared 1-2 weeks after radiotherapy started,and edema started to dissipate one month after treatment.The lesions became smaller and smaller,and dissipated in the end in 65 patients.The lesions became smaller and smaller in the period of radiotherapy in 27 patients,but six months later the lesions appeared larger, twelve cases of them were appeared violation of skull base bone.The lesions became smaller and smaller in the beginning,later fibrosis comfirmed by pathology in 17 patients. There appeared to show radiation encephalopathy following radiotherapy in 9 patients. Conclusions MRI can detect lesion changes before and after radiotherapy in NPC patients,and MRI plays an important role to adjust the treatment program timely by regular follow-up.

Applicational values of MRI imaging after radiotherapy for nasopharyngeal carcinoma

Nasopharyngeal carcinoma Radiotherapy Magnetic resonance imaging