3D-ASL、MRS及DTI对鼻咽癌放射性颞叶损伤的诊断及指导治疗价值

doi:10.3760/cma.j.cn371439-20200603-00076

摘要/Abstract

摘要：

放疗是鼻咽癌的主要治疗方法,随着放疗技术不断提升,鼻咽癌患者的生存期明显延长,但放疗后的并发症越来越受到关注,其中放射性颞叶损伤发生率较高,严重影响了患者的生命质量,甚至降低了生存率。因此寻找早期放射性颞叶损伤的检查方法尤为重要。三维动脉自旋标记成像(3D-ASL)分析放疗前后脑血流量(CBF)变化,磁共振波谱(MRS)测定放疗前后颞叶前后部的NAA/Cr、Cho/NAA、Cho/Cr比值变化,扩散张量成像(DTI)通过测定放疗前后颞叶平均扩散系数(ADC)和各向异性分数(FA)值变化均可帮助早期诊断放射性脑损伤,特别是通过以上3项检测的联合运用,期望能为放射性脑病的早期诊断提供可行的依据,并早期给予营养神经治疗,对改善患者生命质量、提高生存率具有重要意义。

关键词: 磁共振成像, 鼻咽肿瘤, 治疗, 放射性颞叶损伤

Abstract:

Radiotherapy is the main treatment of nasopharyngeal carcinoma (NPC). With the continuous improvement of radiotherapy technology, the survival time of NPC patients is significantly improved, but the complications after radiotherapy have been paid more and more attention, in which the incidence of radiation-induced temporal lobe injury is higher, which seriously affects the quality of life of patients, and even reduces the survival rate. Therefore, it is particularly important to find a method for the examination of early radiation-induced temporal lobe injury. Three-dimensional arterial spin labeling (3D-ASL) analysis of cerebral blood flow (CBF) changes before and after radiotherapy, magnetic resonance spectroscopy (MRS) analysis to determine the changes of NAA/Cr, Cho/NAA, Cho/Cr ratio in the anterior and posterior temporal lobe before and after radiotherapy, and diffusion tensor imaging (DTI) to determine the changes of temporal lobe average diffusion coefficient (ADC) and anisotropy fraction (FA) before and after radiotherapy can help in the early diagnosis of radiation brain injury, especially through the combined use of the above three tests. It is expected to provide a feasible basis for the early diagnosis of radiation encephalopathy, and early nutritional neurotherapy is of great significance to improve the quality of life and survival rate of patients.

Key words: Magnetic resonance imaging, Nasopharyngeal neoplasms, Therapy, Radioactive temporal lobe damage

杨明慧, 金风. 3D-ASL、MRS及DTI对鼻咽癌放射性颞叶损伤的诊断及指导治疗价值[J]. 国际肿瘤学杂志, 2020, 47(9): 550-554.

Yang Minghui, Jin Feng. Value of 3D-ASL, MRS and DTI in the diagnosis and treatment of radiation-induced temporal lobe injury of nasopharyngeal carcinoma[J]. Journal of International Oncology, 2020, 47(9): 550-554.

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