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目的:探讨动态增强磁共振成像在局部晚期鼻咽癌化疗疗效预测中的价值,为进行个体化治疗提供依据。方法:64例2010UICC分期为Ⅲ～Ⅳb期的初治鼻咽癌患者,行TPF方案诱导化疗3周期。诱导化疗前行DCE-MR检查,获取造影剂到达组织时间(T_1 on set),造影剂到达强化高峰时间(TTP),最大信号强度值(SI),强化峰值(PV),强化百分数(SI%)等参数,将其与诱导化疗后肿瘤缩小率进行相关性分析。结果:1)诱导化疗后鼻咽癌原发灶PR24例,NC40例。2)鼻咽癌原发灶缩小率与T_1 on set(r=-0.378,P<0.001)及TTP(r=-0.285,P=0.02)负相关;与SI(r=0.027,P=0.834)、PV(r=0.042,P=0.741)、SI%(r=0.026,P=0.841)无明确相关关系。结论:造影剂到达组织及达到强化高峰时间早的病例化疗后肿瘤缩小率大;肿瘤强化程度与化疗后肿瘤缩小率无相关性;T_1 on set、TTP有可能作为鼻咽癌化疗疗效预测指标之一。
Objective: To investigate the value of dynamic contrast-enhanced magnetic resonance imaging (MRI) in predicting the response of chemotherapy for locally advanced nasopharyngeal carcinoma (NPC), and to provide basis for individualized treatment. Methods: Sixty-four newly diagnosed nasopharyngeal carcinoma patients with stage Ⅲ-Ⅳb of 2010 UICC were treated with TPF regimen for 3 cycles. DCE-MR examination was performed before induction of chemotherapy to obtain T 1 on set, TTP, SI, PV, SI% ) And other parameters, and its induction chemotherapy with tumor shrinkage rate correlation analysis. Results: 1) After induction of chemotherapy, there were 24 cases of primary nasopharyngeal carcinoma and 40 cases of NC. 2) The reduction rate of primary tumor in nasopharyngeal carcinoma was negatively correlated with T 1 on set (r = -0.378, P <0.001) and TTP (r = -0.285, P = 0.02) , PV (r = 0.042, P = 0.741), SI% (r = 0.026, P = 0.841). CONCLUSIONS: Contrast agents reach the tissues and reach the peak of early peak intensified after chemotherapy, and the rate of tumor shrinkage is high. The degree of tumor enhancement is not correlated with the rate of tumor shrinkage after chemotherapy. T 1 on set and TTP may be the predictors of the efficacy of chemotherapy in nasopharyngeal carcinoma one.