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评价Gd-DTPA增强前后MR I在鼻咽癌放疗后复发(RNPC)与放射性纤维化(RF)鉴别诊断中的作用.材料和方法:对MR平扫显示鼻咽部或邻近区域有软组织肿块的28例鼻咽癌放疗后患者行Gd-DTPA增强MR I检查.RNPC22例,RF6例,炎性肿块2例,2例颅底RNPC分别合并鼻咽侧壁RF与炎性病灶.分析病灶形态及信号强度.结果:大多数RNPC病灶表现为TIWI上低信号TZWI高信号,RF在TIWI和T2WI上均显示低或中等信号,平扫两者信号强度区别在于T2WI上,但有一定重叠.增强扫描TIWI示绝大多数RNPC病灶(90.9%)有中度以上明显强化,而RF无或轻度强化,两者信号强度有显著性差异(P<0.01),且增强后肿瘤边界显示更清楚.病灶无强化,可除外RNPC,有强化则不一定是RNPC,明显强化可见于炎性病变.结论:肿块在MR平扫T2WI和增强后TIWI上的信号强度是鉴别RNPC与RF的主要依据,Gd-DTPA增强扫描有助于确定病变性质及其侵犯范围.
To evaluate the role of MRI in the differential diagnosis of nasopharyngeal carcinoma (RNPC) and radioactive fibrosis (RF) before and after Gd-DTPA enhancement.Materials and Methods: MR imaging of nasopharyngeal or adjacent areas with soft tissue mass Twenty-eight patients with nasopharyngeal carcinoma underwent radiofrequency ablation of Gd-DTPA and MRI.RNPC was detected in 22 cases, RF6 cases, inflammatory mass in 2 cases, and 2 cases of skull base RNPC with nasopharyngeal side wall RF and inflammatory lesions respectively. Signal strength.Results: Most of the RNPC lesions showed low signal TZWI high signal on TIWI, RF showed low or moderate signal on both TIWI and T2WI, and the difference of signal intensity between plain scan and T2WI was on T2WI, TIWI showed that the majority of RNPC lesions (90.9%) were significantly enhanced above moderate degree, while no or slight enhancement of RF, the signal intensity was significantly different (P <0.01), and the enhanced tumor border showed more clearly. No enhancement, except for RNPC, with enhancement is not necessarily RNPC, obviously enhanced in inflammatory lesions.Conclusion: The signal intensity of tumor on MR plain scan T2WI and enhanced TIWI is the main basis for identifying RNPC and RF, Gd- DTPA enhanced scan helps determine the nature of the lesion and its extent of invasion.