PDF(Pubmed)
Abstract：
The present study aimed to investigate the value of intravoxel incoherent motion imaging (IVIM) and three-dimensional pulsed continuous arterial spin labeling (ASL) in assessing dynamic changes of the parotid gland in patients with nasopharyngeal carcinoma (NPC) following radiotherapy (RT). A total of 18 patients with NPC who underwent intensity-modulated RT were enrolled in the present study. All patients underwent conventional magnetic resonance imaging, plus IVIM and ASL imaging of the bilateral parotid glands within 2 weeks prior to RT, and 1 week (1W) and 3 months (3M) following RT. Pure diffusion coefficient (D), pseudo-diffusion coefficient (D*), perfusion fraction (F) and blood flow (BF) were analyzed. D and BF values were significantly increased from pre-RT to 1W post-RT [change rate: Median (IQR), ΔD1W%: 39.28% (38.23%) and ΔBF1W%: 60.84% (54.88%)] and continued to increase from 1W post-RT to 3M post-RT [55.44% (40.56%) and ΔBF%: 120.39% (128.74%)]. In addition, the F value was significantly increased from pre-RT to 1W post-RT, [change rate: Median (IQR), ΔF1W%: 28.13% (44.66%)], and this decreased significantly from 1W post-RT to 3M post-RT. However, no significant differences were observed between pre-RT and 3M post-RT. Results of the present study also demonstrated that the D* value was significantly decreased from pre-RT to 1W post-RT and 3M post-RT [change rate: Median (IQR), ΔD*1w%: -41.86% (51.71%) and ΔD*3M: -29.11% (42.67%)]. No significant difference was observed between the different time intervals post-RT. There was a significant positive correlation between percentage change in ΔBF1W and radiation dose (ρ=0.548, P=0.001). Thus, IVIM-diffusion-weighted imaging and ASL may aid in the detection and prediction of radiation-induced parotid damage in the early stages following RT. They may contribute to further understanding the potential association between damage to the parotid glands and patient-/treatment-related variables, through the assessment of individual microcapillary perfusion and tissue diffusivity.
摘要：
本研究旨在探讨体素内不相干运动成像（IVIM）和三维脉冲连续动脉自旋标记（ASL）在评估鼻咽癌（NPC）放疗（RT）后腮腺动态变化中的价值。本研究共纳入18例接受调强RT的NPC患者。所有患者均接受常规磁共振成像,在RT前2周内加上双侧腮腺的IVIM和ASL成像，RT后1周（1W）和3个月（3M）。纯扩散系数(D),伪扩散系数(D*)，灌注分数（F）和血流量（BF）进行分析。从RT前到RT后1W，D和BF值显着增加[变化率：中位数（IQR），ΔD1W%:39.28%(38.23%)和ΔBF1W%:60.84%(54.88%)]并且从RT后的1W继续增加到RT后的3M[55.44%(40.56%)和ΔBF%:120.39%(128.74%)]。此外,F值从RT前显著增加到RT后1W，[变化率：中位数（IQR），ΔF1W%：28.13%（44.66%）]，从RT后的1W到RT后的3M显着下降。然而,RT前和3M后没有观察到显著差异。本研究的结果还表明，D*值从RT前显著降低到RT后1W和RT后3M[变化率：中位数（IQR），ΔD*1w%:-41.86%(51.71%)和ΔD*3M:-29.11%(42.67%)]。在RT后的不同时间间隔之间没有观察到显著差异。ΔBF1W的百分比变化与辐射剂量之间存在显着正相关（ρ=0.548，P=0.001）。因此，IVIM扩散加权成像和ASL可能有助于在RT后的早期阶段检测和预测辐射引起的腮腺损伤。他们可能有助于进一步了解腮腺损伤与患者/治疗相关变量之间的潜在关联。通过评估个体微毛细血管灌注和组织扩散率。
