Risk Factors And Countermeasures Of Radiation Brain Injury In Nasopharyngeal Carcinoma Missed By Magnetic Resonance Imaging

Objectives: To explore the causes of magnetic resonance missed diagnosis of radiation-induced temporal lobe injury in nasopharyngeal carcinoma(NPC)and put forward corresponding measures to improve the early diagnosis rate of RTLI and reduce missed diagnosis.Materials and methods: The MRI images and original reports of patients with nasopharyngeal carcinoma discharged from Xiangya Hospital from January 2010 to April 2021 were retrospectively analyzed.The demographic characteristics of missed and non-missed RTLI patients,the imaging features of TNM and RTLI lesions of nasopharyngeal carcinoma were compared,and the causes of missed diagnosis of RTLI were discussed.The structural template was designed and used to re-read the film,and the missed diagnosis rate and focus missed diagnosis rate were compared between the original report and the re-reading film.Results: It was found that there were 187 patients with RTLI(bilateral:51;unilateral: 136),the missed diagnosis rate of original reported diseases was 64.2%,and the missed diagnosis rate of lesions was 59.7%.There was no significant difference in age,sex and TNM stage of nasopharyngeal carcinoma between the two groups.The variables of P < 0.05 in univariate analysis were included in multivariate Logistic regression,and the lesion size(OR: 10.402,95%CI: 3.667-29.507,P < 0.001),location of lesions(OR: 3.085,95%CI: 1.225-7.768,P = 0.017)and nasopharyngeal MRI(OR:17.563,95%CI: 4.257-72.464,P < 0.001)were independent risk factors for missed diagnosis of RTLI lesions by MRI.After re-reading the film using the structured template,the missed diagnosis rate of the disease was40.6%,and the missed diagnosis rate of the focus was 39.1%,which was significantly lower than that of the original report(P < 0.001).Conclusion: The attention of radiologists to the temporal lobe and the location and size of the lesions are the main reasons for the missed diagnosis of nasopharyngeal carcinoma by RTLI.The structural report of MRI and the increase of craniocerebral MRI in nasopharyngeal MRI after radiotherapy are helpful to reduce the missed diagnosis of RTLI in nasopharyngeal carcinoma.