鼻咽癌颈部淋巴结放射敏感性与CT灌注扫描相关性研究
鼻咽肿瘤,鼻咽肿瘤；淋巴结；体层摄影术；X线计算机；放射敏感性,1资料与方法,2结果,3讨论
【摘要】 目的 初步探讨螺旋CT灌注成像扫描在预测鼻咽癌颈部转移淋巴结放射敏感性的应用价值。方法 对经病理证实的45例鼻咽癌行治疗前螺旋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数据。外照射至DT50Gy时行鼻咽部和颈部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。结果 Pearson相关分析结果显示各灌注参数中仅血容量(BV)与RS0-50有直线相关关系。将RS0-50≤0.75定为放射治疗低敏感组，RS0-50>0.75为高敏感组，结果显示：高敏感组血流量(BF)和BV值明显高于低敏感组，BF[ml/(min·100g)]分别为 287.1±131.1和246.1±118.1(t=2.05，P=0.03)；BV(ml/100g)分别为7.1±3.4和5.4±3.1 (t=3.31，P=0.002)。结论 螺旋CT动态灌注扫描所测的鼻咽癌颈部转移淋巴结的血容量有预测放射敏感性的前景，但还需要更进一步的研究。【关键词】 鼻咽肿瘤；淋巴结；体层摄影术；X线计算机；放射敏感性
Predicting the radiation sensitivity of neck metastasis lymph node of nasopharyngeal carcinoma: value of tumor perfusion measured by dynamic computed tomography
YUAN Zhi-yong, LIU Hong-wei，LU Hong.
Department of Oncology, The 2nd Teaching Hospital of Xiangya Medical College, Central South University, Changsha 410011，China
【Abstract】 Objective To investigate the value of of neck metastasis lymph node perfusion measured by dynamic computed tomography in predicting the radiation sensitivity of nasopharyngeal carcinoma (NPC). Methods 45 patients have pathologically proven NPC were studied prospectively with dynamic computed tomography (dCT). Recorded the perfusion data of the of neck metastasis lymph node and uninvolved lateral pterygoid muscle. All patients received conventional radiation therapy and received CT scan when the radiation dose was 50Gy. Measured the tumor sizes (WHO rule) before treatment and at the time of 50Gy. Tumor size regression percent (RS0-50: the tumor size regressed at the time of 50Gy versus tumor size before treatment) was correlated with perfusion data. Pearson linear regression method was used. Results Using linear regression, the tumor regression rate (RS0-50) is related to BV (blood volume) (P=0.001), while there is no correlation was found between tumor regression rate (RS0-50) and BF, MTT and PS value. Divided the patients into two groups: the high-radiation-sensitivity group with RS0-50 more than 0.75, the low-radiation-sensitivity group with RS0-50 no more than 0.75. Compare the perfusion values of the two groups: BF, BV, MTT, PS. Using t test, the difference of BF(blood flow)(P=0.03)and BV(P=0002)between the two groups is statistically significant.Conclusion Dynamic CT determined perfusion measurements of nasopharyngeal carcinomas are feasible. BV (tumor blood volume) have the potential value to be a prognostic factor for outcome after radiotherapy, but further study needed. ......
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