动态对比增强磁共振成像对鼻咽癌临床分期的诊断价值评价

目的:探讨DCE-MRI各项参数对鼻咽癌临床分期的诊断价值。方法:纳入2016年1月至2019年12月确诊的208例NPC初诊患者为研究对象,均行DCE-MRI、DWI检查,分析临床分期不同的患者感兴趣区的转运常数（Ktrans）、血管外细胞外间隙体积百分数（Ve）、速率常数（Kep）、容积分数（fPV）、DWI表观扩散系数（ADC值）,考察指标与NPC临床分期的相关性。结果:Ktrans、Ve值随NPC临床分期增加而增大,而ADC值则随之减小,随着T分期增加Ve值增加,Kep、fPV值则在不同分期均未见明显差异（P＞0.05）;相关性结果显示,Ktrans、Ve值与临床分期、T分期呈正相关,而ADC值呈负相关（P均<0.05）;ROC曲线分析结果显示,Ktrans曲线下面积最高,为0.915,而早期（I期、Ⅱ期）、晚期（Ⅲ期与Ⅳ期）的AUC分别为0.906、0.920,均高于DWI ADC（AUC分别为0.824、0.807）。结论:DCE-MRI测量参数可反映不同临床分期NPC的变化,可考虑用于NPC不同分期的诊断、疗效评价。

Explore the diagnostic value of dynamic contrast-enhanced magnetic resonance imaging in clinical staging of nasopharyngeal carcinoma

Objective:To explore the diagnostic value of DCE-MRI parameters in the clinical staging of nasopharyngeal carcinoma.Methods:208 newly diagnosed NPC patients diagnosed from January 2016 to December 2019 were included in the study.All patients were examined by DCE-MRI and DWI,then the transport constant(Ktrans),extravascular extracellular space volume percentage(Ve),rate constant(Kep),volume fraction(fPV),DWI apparent diffusion coefficient(ADC value) of NPC patients in different stages were analyzed,and examine the correlation between the corresponding index and the clinical stage of NPC.Results:The values of Ktrans and Ve increased with the increase of clinical stage of NPC,while the value of ADC decreased.With the increase of T stage,the Ve value increased,and the Kep and fPV values showed no significant difference in different stages(P＞0.05).Spearman correlation results showed that Ktrans and Ve values were positively correlated with clinical stage and T stage,while ADC values were negatively correlated(P＜0.05).ROC curve analysis showed that the area under the Ktrans curve was the highest at 0.915,and the AUCs for the diagnosis of NPC in early(stage Ⅰand Ⅱ) and late (stage Ⅲ and Ⅳ) were 0.906 and 0.920,respectively,higher than DWI ADC (AUC was 0.824,0.807,respectively).Conclusion:The measurement parameters of DCE-MRI can reflect the changes of NPC in different clinical stages,and can be considered for the diagnosis and efficacy evaluation of different stages of NPC.