~(125)I粒子植入治疗鼻咽癌患者的CT及MRI影像改变随访研究

目的探讨~(125)I粒子植入治疗鼻咽癌患者的疗效及CT与MRI在患者治疗后随访中的应用价值。方法纳入2011年1月-2014年12月我院收治57例鼻咽癌患者作为研究对象,患者均于放疗后予以~(125)I粒子植入治疗,于治疗前对患者进行CT及MRI检查并进行随访,明确患者经~(125)I粒子植入治疗后CT与MRI影像改变。结果 57例患者中12例为CR、28例为PR、9例为SD、8例为PD,治疗总有效率为70.2%(40/57)。治疗后患者ESR明显下降,低于治疗前,差异有统计学意义(P0.05)。治疗前后CT表现:~(125)I粒子植入治疗前鼻咽腔形态改变,左右不对称,鼻咽部软组织增厚或出现肿块,病灶多为结节状、厚片块状或团块状高代谢病灶;治疗后鼻咽腔形态得到恢复,软组织增厚或出现肿块消失;治疗前后MRI表现:~(125)I粒子植入治疗前主要表现为鼻咽部混杂信号、水肿,等或长T1稍长T2异常信号结节或肿块影,增强压脂后明显强化;治疗后以纤维化出现为主要特征,可伴水肿。结论放疗后于CT引导下应用~(125)I粒子植入治疗鼻咽癌具有较佳效果,于患者治疗后应用CT及MRI进行随访可及时发现病灶变化,对于预后监测意义重大。

Follow-up Study of CT and MRI Images Changes in Patients with Nasopharyngeal Cancer Treated by Implantation of Radioiodine-125 Particles

Objective To explore the curative effect of implantation of radioiodine-125 particles in the treatment of patients with nasopharyngeal cancer and the application value of CT and MRI in the follow-up of patients after treatment.Methods 57 cases of patients with nasopharyngeal cancer who were treated in our hospital between January 2011 and December 2014 were included in the study. All patients were treated with implantation of radioiodine-125 particles after radiotherapy. Before treatment, the patients were examined by CT and MRI and were followed up. The CT and MRI image changes after implantation of radioiodine-125 particles were determined.Results Among the 57 cases, 12 cases were CR, 28 cases were PR, 9 cases were SD and 8 cases were PD and the total effective rate was 70.2% (40/57). After treatment, ESR decreased significantly and was lower than that before treatment (P<0.05). CT findings before and after treatment showed that before implantation of radioiodine-125 particles, the shape of nasopharyngeal cavity changed, left-right asymmetry. Nasopharyngeal soft tissues thickened or with presence of masses. The lesions mostly were nodular, thick piece lump-like or mass high metabolic; After treatment, the shape of nasopharyngeal cavity was recovered. Soft tissues became thicker or the masses disappeared; MRI findings before and after treatment showed that before implantation of radioiodine-125 particles, the main findings were presence of mixed signal and edema in nose and throat, equal or long T1 , slightly long T2 abnormal signal of nodule or mass shadow. After enhancement of fat-suppression, they were significantly enhanced. After treatment, the main feature was presence of fibrosis, complicated with edema.Conclusions The application of implantation of radioiodine-125 particles under CT in the treatment of nasopharyngeal cancer after radiotherapy is of relatively better effect. To apply CT and MRI in follow-up after treatment can find changes of the lesions in time, which is of important significance in monitoring prognosis.