多层螺旋CT灌注成像对鼻咽癌复发的诊断价值研究

目的研究MSCT灌注成像对鼻咽癌复发和放疗后纤维化的鉴别诊断价值。方法对病理证实的鼻咽部鳞状细胞癌治疗前组46例、放疗后局部复发组26例、放疗后纤维化组17例（三组共89例）进行鼻咽部CT灌注成像扫描，分析各组病灶区局部的TDC和灌注参数特点及其差异，确定治疗前组病灶的灌注参数阈值并计算其对敢疗后局部复发瘤诊断的敏感性和特异性。结果治疗前组和放疗后复发组之TDC形态与纤维化组明显不同。治疗前组和放疗后局部复发组BF、BV、PS值均高于放疗后纤维化组，MTT值均低于纤维化组，且各组灌注值均存在显著统计学差异（P〈0.05）；治疗前组与放疗后局部复发组各灌注值均无统计学差异（P〉0.05）。鼻咽癌治疗前组BF、BV、MTT和PS闳值分别为337.20ml·min·100g、10.18ml·100g^-1、3.89s和24.24ml·min^-1·g^-1，各阈值对鼻咽癌放疗后局部复发瘤的诊断敏感性分别为96.15％、9.615％、75.08％和57.69％，特异性分别为100％、100％、76.47％和76.47％。结论MSCT灌注成像技术和鼻咽癌灌注参数阈值对鼻咽癌放疗后复发瘤的诊断和鉴别诊断具有重要价值。

Study on Diagnostic Value of Multi-slice Spiral CT Perfusion in Recurrent Nasopharyngeal Squamous Cell Carcinoma

Objective To study the value of multi-slice spiral CT (MSCT) prefusion in recurrent nasopharyngeal squamous cell carcinoma,and its diagnostic value for differentiating post-radiotherapy local recurrence tumor from fibrosis. Methods A total 89 patients including 46 patients with pre-treatment NPC,26patiens with post-radiotherapy local recurrence and 17 patients with local fibrosisafter radiotherapy were undergone CT perfusion scanning. The perfusion parameters in each were calculated and analysed statiscally...