[磁共振扩散加权成像评估调强放疗对鼻咽癌患者唾液腺功能影响的研究]

[Study on DWMRI in evaluating the influence of intensity modulated radiotherapy on salivary gland function of nasopharyngeal carcinoma patients].

作者信息

Li Yanjie, Zhao Changqing

机构信息

Department of Ophthalmology, First Hospital of Shanxi Medical University, Taiyuan 030001, China.

Department of Otorhinolaryngology Head and Neck Surgery, the Second Hospital of Shanxi Medical University, Taiyuan 030001, China; Email:

出版信息

Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2015 Sep;50(9):754-9.

PMID:26696349

Abstract

OBJECTIVE

To evaluate the dynamic change of salivary gland function in patients with nasopharyngeal carcinoma (NPC) before and after intensity modulated radiotherapy (IMRT) by DWMRI.

METHODS

Twenty-three NPC patients confirmed by pathology were enrolled. Male/Female: 19/4. The age was from 37 to 69 years. All cases underwent salivary glands examination by DWMRI before IMRT, at the end of IMRT, 6 months and 12 months after IMRT, at the same time the ADC value of salivary glands were calculated. The patients were divided into two groups: G1, Dmean < 26 Gy, G2, Dmean ≥ 26 Gy. SPSS 13.0 and SAS 8.2 software was used to analyze the date.

RESULTS

The ADC values of parotid in two group patients at rest were not significantly different between 6 months after and at the end of IMRT (t value was 0.732, 1.405, all P > 0.05). The ADC values of parotid in two group patients at rest were significantly lower in the 12 months after IMRT than at the end of IMRT (t value 2.621, 3.417, all P < 0.05). During the period of acid stimulation, A significant change of ADC in parotid was found in G1 (all P < 0.05) and no significant change of ADC in parotid was found in G2 at the various follow-up time after IMRT (all P > 0.05). At the various follow-up time after IMRT, the average ADC values of parotid were significantly higher in G2 than G1 in the same time points of acid stimulation (all P < 0.05). The ADC values of submandibular glands at rest were significantly higher at the various follow-up time after IMRT than before IMRT (t value was -9.782, -8.963, -7.722, all P < 0.05). During the period of acid stimulation no significant change of ADC in submandibular glands was found after IMRT (F = 1.124, P = -0.348).

CONCLUSIONS

The changes of salivary function can be well reflected by ADC values. There is a good clinical application value of DWMRI for evaluating radiation-induced salivary glands functional changes and observing salivary function recovery during the follow-up period after IMRT.

摘要

目的

通过扩散加权磁共振成像（DWMRI）评估鼻咽癌（NPC）患者调强放疗（IMRT）前后唾液腺功能的动态变化。

方法

纳入23例经病理确诊的NPC患者。男/女：19/4。年龄37至69岁。所有病例在IMRT前、IMRT结束时、IMRT后6个月和12个月均接受DWMRI唾液腺检查，同时计算唾液腺的表观扩散系数（ADC）值。患者分为两组：G1组，平均剂量（Dmean）<26 Gy；G2组，Dmean≥26 Gy。采用SPSS 13.0和SAS 8.2软件进行数据分析。

结果

两组患者腮腺在IMRT后6个月与IMRT结束时静息状态下的ADC值差异无统计学意义（t值分别为0.732、1.405，均P>0.05）。两组患者腮腺在IMRT后12个月静息状态下的ADC值均显著低于IMRT结束时（t值分别为2.621、3.417，均P<0.05）。在酸刺激期间，G1组腮腺的ADC有显著变化（均P<0.05），而G2组在IMRT后的各随访时间腮腺的ADC无显著变化（均P>0.05）。在IMRT后的各随访时间，在酸刺激的相同时间点，G2组腮腺的平均ADC值均显著高于G1组（均P<0.05）。颌下腺在IMRT后各随访时间静息状态下的ADC值均显著高于IMRT前（t值分别为-9.782、-8.963、-7.722，均P<0.05）。在酸刺激期间，IMRT后颌下腺的ADC无显著变化（F=1.124，P=-0.348）。