| ObjectiveDiscussion and analysis of 3.0T MRI Dynamic contrast-enhanced Imaging(DCE-MRI)and Diffusion Tensor Imaging(DTI),i.e.using multi-parameter imaging to assess and predict the value of effect of TP-induced chemotherapy.MethodsAccording to the inclusion criteria and exclusion criteria,51 patients who were initially diagnosed as stage Ⅲ primary nasopharyngeal carcinoma in the First Affiliated Hospital of Jinzhou Medical University from September 2017 to December 2019 were divided into experimental group and Control group.In the experimental group,all patients need to complete the whole course of docetaxel combined with cisplatin(TP)induction chemotherapy regimen and Radiochemical therapy(IMC)of radiochemical synchronization with continuous intensity modulation and complete 3 times 3.0T DCE-MRI and DTI MRI examinations(i.e.before IC,within one week after IC two cycles and one month after IMC).In the control group,were treated with intensity-modulated Radiochemical synchronization therapy and complete 2 times 3.0T DCE-MRI and DTI-MRI examinations(i.e.before treatment and one month after IMC).Measure and record the maximum the largest diameter D of the Patient’s nasopharynx in the two groups at different stages of treatment,Initial strengthening rate of semi quantitative parameters IER,Maximum strengthening rate MER,TIC type of time signal curve,The FA value of the diffusion-related anisotropy fraction in the ipsilateral temporal lobe of the lesion,separately calculate the rate of change of different parameters Δ D%,Δ MER%,Δ FA%between treatment stages.According to the evaluation criteria of solid tumors,the therapeutic effects were divided into response sensitive group(RSG)and non response sensitive group(NRG).The data were statistically analyzed by t test and chi-square test to judge the curative effect.Results1.Statistical differences were found in the maximum diameter and the corresponding rate of change at each stage of treatment between the therapeutically sensitive group and the experimental and control groups.The maximum diameter of the lesion was significantly reduced after two course of IC.The rate of change of the maximum diameter of the lesion before and after IC was higher than that of the maximum diameter after the two cycles of IC to the end of the overall treatment.2.The IER and MER of each stage of the lesion were statistically different between the sensitive groups.The IER and MER were significantly decreased after the two cycles of IC.The rate of change ΔIER%and ΔMER%before and after induction chemotherapy also showde statistical differences between sensitive groups.The IER and MER of the lesion during the same treatment stage were not statistically different between the experimental and control groups.3.The TIC curve type was statistically significant in the contrast-sensitive groups.The RSG curve followed a rapid rise-platform-slow fall pattern.NRG shows a rapid rise-rapid TIC curve type.4.After IMC treatment,the FA value decreased and there was a statistical difference between the experimental group and the control group.There was no statistical difference in FA values before and after IC.Conclusions1.Multi-parameter magnetic resonance imaging maximum diameter D,rate of change ΔD%,semi-quantitative parameters IER,MER,rate of changeΔMER%and TIC curve types all have the value of non-invasively predicting and evaluating the efficacy in the early stage of TP induction chemotherapy.2.The use of TP-induced chemotherapy does not aggravate the risk of temporal lobe nerve injury and effectively reduce the lesion,but it has a limited effect on improving the hemodynamics of the lesion to improve the efficacy. |
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