Zhou S, Qian J J, Xu L, Tian Y, Fan Q H, Shen J K, Fan G H, Gong J P, Qian M H
Department of Radiology, the Second Affiliated Hospital of Soochow University, Suzhou 215004, China.
Zhonghua Yi Xue Za Zhi. 2017 Feb 21;97(7):492-495. doi: 10.3760/cma.j.issn.0376-2491.2017.07.004.
To quantitatively evaluate the early radiation injury of salivary glands in patients with nasopharyngeal carcinoma (NPC) after intensity-modulated radiotherapy (IMRT). Twenty patients with NPC between 2014 and 2015 from the Second Affiliated Hospital of Soochow University were retrospectively analyzed.All patients underwent an MRI scan before and after IMRT.The volumes, T(1)WI, T(2)WI signal intensity(SIs) and apparent diffusion coefficient (ADCs) of the parotid and submandibular glands were measured.The relative signal intensity (RSIs) of each salivary gland was calculated with cerebrospinal fluid as control.The quantitative parameters of salivary glands were compared before and after radiotherapy. The volumes (cm(3)) and T(1)WI RSIs of the parotid and submandibular glands (14.88±6.00, 5.21±1.76, 2.98±1.05, 1.88±0.42, respectively) were significantly lower than those before radiotherapy (22.26±8.26, 7.76±2.45, 3.58±1.02, 2.27±0.50, respectively) (=9.921, 4.013, 10.126, 4.202, respectively, =0.000 for all). The T(2)WI RSIs and ADCs (×10(-3) mm(2)/s) of the parotid and submandibular glands (0.50 ± 0.08, 0.41±0.04, 1.31±0.19, 1.50±0.13, respectively) were significantly higher than those before radiotherapy (0.45±0.07, 0.33±0.05, 1.02±0.21, 1.23±0.13, respectively) (=-4.846, -9.276, -9.957, -10.679, respectively, =0.000 for all). The volumes of parotid and submandibular glands were correlated with ADCs (=-0.512, =0.000; =-0.358, =0.001; respectively). The volumes and ADCs of submandibular glands were correlated with T(1)WI RSIs and T(2)WI RSIs(<0.05). MRI can quantitatively evaluate the early changes of salivary glands after radiotherapy of nasopharyngeal carcinoma as a noninvasive method, and has high clinical application potential.
定量评估鼻咽癌（NPC）患者调强放疗（IMRT）后唾液腺的早期放射性损伤。回顾性分析2014年至2015年苏州大学附属第二医院的20例NPC患者。所有患者在IMRT前后均接受了MRI扫描。测量腮腺和颌下腺的体积、T(1)WI、T(2)WI信号强度（SIs）和表观扩散系数（ADCs）。以脑脊液为对照计算各唾液腺的相对信号强度（RSIs）。比较放疗前后唾液腺的定量参数。腮腺和颌下腺的体积（cm³）和T(1)WI RSIs（分别为14.88±6.00、5.21±1.76、2.98±1.05、1.88±0.42）显著低于放疗前（分别为22.26±8.26、7.76±2.45、3.58±1.02、2.27±0.50）（分别为9.921、4.013、10.126、4.202，均P = 0.000）。腮腺和颌下腺的T(2)WI RSIs和ADCs（×10⁻³ mm²/s）（分别为0.50 ± 0.08、0.41±0.04、1.31±0.19、1.50±0.13）显著高于放疗前（分别为0.45±0.07、0.33±0.05、1.02±0.21、1.23±0.13）（分别为-4.846、-9.276、-9.957、-10.679，均P = 0.000）。腮腺和颌下腺的体积与ADCs相关（分别为r = -0.512，P = 0.000；r = -0.358，P = 0.001）。颌下腺的体积和ADCs与T(1)WI RSIs和T(2)WI RSIs相关（P<0.05）。MRI作为一种非侵入性方法可定量评估鼻咽癌放疗后唾液腺的早期变化，具有较高的临床应用潜力。
