| Objective: To explore the clinical application value of diffusion-weighted imaging（DWI） magnetic resonance in follow-up re-examination of nasopharyngealcarcinoma（NPC） after radiotherapy treatment.Material and methods：83NPC patients confirmed by followed-up or pathology afterradiotherapy treatment were divided into tumor residual group and non-residual groupwithin6months, recurrent group and non-recurrent group over6months, MRI andDWI were analyzed in details, the ADC of nasopharyngeal residual mass and（or）nasopharyngeal wall thicken, skull base destruction and lateral pterygoid muscle weremeasured．Results：1. In the33non-residual cases, justo of cavum nasopharyngeum（n=10）, distortion ofcavum nasopharyngeum（n=25）, nasopharyngeal wall thicken（n=28）, nasopharyngealand（or） parapharyngeal residual mass （n=17）, arrowing or disappearance ofnasopharyngeal space（n=17）, skull base residues encroached（n=6）, lamina of thesphenoid bone destruction（n=2）, the ADC of nasopharyngeal wall thicken andnasopharyngeal or parapharyngeal residual mass was （1.843±0.133）×10-3mm2/s.2. In the4residual cases, nasopharyngeal wall thicken（n=2）, nasopharyngeal and（or）parapharyngeal residual mass （n=2）, narrowing or disappearance of nasopharyngealspace（n=2）,corpus of the sphenoid bone destruction（n=1）,clivus destruction （n=1）, the ADC of residual was （1.097±0.183）×10-3mm2/s.3. In the41non-recurrent cases, justo of cavum nasopharyngeum（n=12）, distortion ofcavum nasopharyngeum（n=29）, nasopharyngeal wall thicken（n=31）, nasopharyngealand（or） parapharyngeal residual mass （n=25）, narrowing or disappearance ofnasopharyngeal space（n=21）, skull base residues destruction （n=2）, the ADC ofnasopharyngeal wall thicken or medial soft tissue of nasopharyngeal and（or）parapharyngeal was（1.884±0.134）×10-3mm2/s.4. In the5recurrent, nasopharyngeal wall thicken（n=5）, nasopharyngeal and（or）parapharyngeal residual mass （n=5）, skull base residues destruction（n=3）, corpus ofthe sphenoid bone destruction （n=1）, narrowing or disappearance of nasopharyngealspace（n=5）, the ADC of recurrent was （0.787±0.067）×10-3mm2/s.By statistical analysis, the ADC of residual and recurrent was lower than themuscles pterygoideus lateralis, but non-residual and non-recurrent was higher thanthem, there were significant difference among in them（P＜0.05）.Conclusion MRI can show the changes in NPC after radiotherapy, especially in theaspect of DWI, it can provide qualitative and quantitative information at cellular levelabout tumor, measuring the ADC of the region of interest, which were sensitive andaccurative for differential diagnosis of post-radiotherapy residual nasopharyngealcarcinoma, local-fibrosis patients and local recur patients. |
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