摘要
【目的】探讨多层螺旋CT（MSCT）灌注扫描在鼻咽癌颈部转移淋巴结放疗敏感性预测中的价值。【方法】对经病理确诊的43例低分化鼻咽部鳞癌行放疗前CT动态扫描，计算颈部转移淋巴结和未受侵犯的翼外肌的灌注参数。外照射至DT50Gy时进行颈部和鼻咽部位CT复查，分别测量治疗前和DT50Gy时颈部转移淋巴结最大截面积。分析各灌注参数与肿瘤消退率（RS0—50）关系；将RS0—50≤0．75定为放疗低敏感组，RS0—50〉0．75为放疗高敏感组，分析灌注参数与放疗敏感性的关系。【结果】①与肌肉组织比较，颈部转移淋巴结的血流量（BF）、血容量（BV）、表面通透性（PS）显著增高（P〈0．01），平均通过时间（MTT）则显著降低（P〈0．01）。②BV与RS0—50有直线相关关系。③放疗高敏感组BF、BV值显著高于放疗低敏感组。【结论】鼻咽癌颈部转移淋巴结的CT灌注参数BV、BF能预测其对放疗的敏感性，有助于实行个体化治疗。
[Objective]To explore the value of multi-slice computed tomography（MSCT） perfusion scanning for predicting the radiosensitivity of neck lymph node metastasis in nasopharyngeal carcinoma（NPC）. [Methods] Forty three patients who were pathologically diagnosed as poorly differentiated NPC received dynamic computed tomography （dCT） before radiotherapy. Perfusion parameters of metastasis neck lymph node and uninvolved lateral pterygoid muscle were calculated. CT was performed again when the radiation dose was 50Gy. Maximum section area of metastasis neck lymph node before therapy and at the time of 50Gy was measured. The relationship between perfusion parameters and tumor regression rate（RS0-50） was analyzed. The low radiosensitive group was RS0-50〉0.75 and the high radiosensitive group was RS0-50〉0.75. The relationship.between perfusion parameters and radiosensitivity was analyzed. [Results] Compared with muscle tissue, the blood flow（BF）, blood volume （BV） and the permeability of the surface（PS） of metastasis neck lymph node increased significantly（ P〈0.01）, and the mean transit time（MTT） decreased significantly（ P〈0.01）. There was linear correlation between BV and RS0-50. BF and BV in high radiosensitive group were significantly higher than those in low radiosensitive group. [Conclusion] CT perfusion parameters（i, e. BV and BF） of neck lymph node metastasis of NPC can predict the radiosensitivity and is helpful for individualized treatment.
出处
《医学临床研究》
CAS
2010年第8期1439-1440,1443,共3页
Journal of Clinical Research
