【摘要】 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（T₁ 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T₁ 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;T₁ on set、TTP有可能作为鼻咽癌化疗疗效预测指标之一。更多还原

【Abstract】 Objective:To investigate the value of dynamic contrast-enhanced magnetic resonance(DCE-MR) in predicting the chemotherapy efficacy of locally advanced nasopharyngeal carcinoma,thereby providing a more reliable basis for making personalized treatment plans.Methods:Sixty-four patients were pathologically diagnosed as having nasopharyngeal carcinoma in stageⅢ-Ⅳb 2010U1CC. They were treated by TPF regimen(Docetaxel+Cisplatin+ 5-Fluorouracil) in 3 cycles.Before undergoing induction chemotherapy,they received DCM-MRI to obtain the time at arrival of contrast inflow(Tl on set),time to peak(TTP),maximum of signal intensity(SI),peak value(PV),and percent of signal intensity(SI%).The relationship between DCM-MR parameters and tumor regression rate after induction chemotherapy is investigated.Results:1) A total of 24 cases achieved PR and 40 cases achieved NC.2)T1 on set and TTP negatively correlated to regression rate of primary tumor(-0.378 and -0.285,P<0.001 and P=0.02).PV(0.027,P=0.834),SI(0.042,P=0.741),and SI% (0.026,P = 0.841) have no correlation with tumor regression rate.Conclusion:1) Patients with sooner Tl on set and TTP have a greater tumor regression rate.2)Tumor enhancement degree and tumor regression rate after chemotherapy have no correlation.3)DCM-MR parameters, such as TTP and Tl on set,can be used to predict the curative effect of induction chemotherapy.更多还原