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目的探讨鼻咽癌放疗计划设计中CT和MRI确定肿瘤靶区(GTV)的价值比较。方法分析经病理证实的39例NPC患者的影像学资料,治疗前1周内均有CT和MRI资料。CT扫描采用GE Lightspeed型16排螺旋CT机,常规轴位平扫。MRI检查使用GE Signa 1.5Tesla超导磁共振成像系统,标准头部正交线圈,常规SE序列,扫描方向为横断面、矢状面和冠状面,10例增加FLAIR序列,扫描范围上至鞍上池,下至第2颈椎下缘水平。部分病例行Ultravist CT扫描或/ 和GD-DTPA MR扫描。统计方法为配对t检验。结果CT组和MRI组勾画的靶区中,肿瘤平均体积分别为32.49±19.91cm3,29.06±18.75cm3,二组对比具有极显著性差异(t= 5.268,P=0.000)。早期(T1+T2)和进展期(T3+T4)二组对比有极显著性差异(t=5.677,P=0.000;t=3.310,P=0.005)。在T1、T2、13期中二组对比差异明显(P值分别为0.005、0.001和0.004),而在T4期中二组对比无统计学意义(P=0.146)。结论MRI组勾画靶区较CT组精确。因此,建议在鼻咽癌肿瘤靶区勾画中应以MRI较为适合。
Objective To investigate the value of CT and MRI in the design of radiotherapy for nasopharyngeal carcinoma (NPC) to determine the target of tumor (GTV). Methods The imaging data of 39 NPC patients confirmed by pathology were analyzed. CT and MRI data were obtained within 1 week before treatment. CT scan using GE Lightspeed 16-slice spiral CT machine, conventional axial plain scan. MRI examination using GE Signa 1.5Tesla MR system, the standard head quadrature coil, the conventional SE sequence, the scan direction for the cross-section, sagittal and coronal plane, 10 cases increased FLAIR sequence, scanning range up to the saddle Pool, down to the 2nd cervical vertebra margin level. Some cases underwent Ultravist CT scan or / and GD-DTPA MR scan. Statistical methods for the paired t test. Results The average volume of tumors in CT and MRI groups were 32.49 ± 19.91 cm3 and 29.06 ± 18.75 cm3, respectively. There was a significant difference between the two groups (t = 5.268, P = 0.000). There was a significant difference between the two groups (t = 5.677, P = 0.000; t = 3.310, P = 0.005) in the early stage (T1 + T2) and advanced stage (T3 + T4). There were significant differences between the two groups at T1, T2 and 13 (P = 0.005, 0.001 and 0.004 respectively), but there was no significant difference between the two groups in T4 (P = 0.146). Conclusion MRI group is more accurate than CT group. Therefore, it is suggested that MRI should be more suitable for NPC target mapping.