目的 本文旨在探讨动态增强 MRI(DCE-MRI)与鼻咽癌放化疗患者预后的 评估作用。方法 选取2011年1月至2014 年12月我院鼻咽纤维镜病理活检证实的 鼻咽癌患者77例，放化疗前行DCE-MRI以 采集相关参数，包括正性增强积分PEI、 最大上升斜率MSI、最大下降斜率MSD、 达峰时间TTP等。同时采用免疫组化方法 检测HIF-1α的表达，利用Kaplan-Meier 曲线分析患者的生存率。结果 HIF-1α 的阳性率为75.57％。与HIF-1α阴性的 患者相比较，HIF-1α阳性的患者的缓解 率、控制率、生存率明显降低，肿瘤转移 率明显增高(P<0.05)。另外，HIF-1α阳 性的患者的第1、2、3年的无瘤生存率明 显低于HIF-1α阴性的患者(P＜0.05)。 与HIF-1α阴性患者相比，HIF-1α阳性 患者的MSD、PEI、MSI和TTP显著增高(P ＜0.05)。结论 DCE-MRI相关参数与HIF1α阳性高度相关，预示着鼻咽癌放化疗 患者预后不良，对于鼻咽癌预后的评估具 有重要的价值。

Objective To explore the effect of dynamic contrast-enhanced MRI (DCEMRI) in the prognosis evaluation of patients with nasopharyngeal carcinoma treated by chemoradiotherapy. Methods 77 patients with nasopharyngeal carcinoma confirmed by nasopharyngeal fiberscope pathological biopsy in our hospital during January 2011 to December 2014 were selected in this study, all the patients were collected related parameters by DCE-MRI before chemoradiotherapy, it including Positive Enhancement Integral (PEI), maximal slope increasing (MSI), maximal slope descending (MSD), tmax (TTP) and so on. At the same time the expression of HIF-1α was assayed by immunohistochemical staining, using of Kaplan-Meier curve analysis of survival rate. Results The positive rate of HIF-1α was 75.57％. The remission rate, control rate and survival rate were significantly reduced, tumor metastasis rate was significantly increased of HIF-1α alpha positive patients than HIF-1α alpha negative patients(P<0.05). Otherwise, the 1,2,3 years of recurrence free survival rate was less of HIF-1αalpha positive patients than HIF - 1 alpha negative patients(P<0.05). The MSD、PEI、MSI and TTP were significantly increased of HIF-1α alpha positive patients than HIF-1α alpha negative patients(P<0.05). Conclusion DCE-MRI parameters correlated with HIF1α highly positive, it indicates that chemotherapy in patients with nasopharyngeal put poor prognosis, and it has an important value for the prognosis evaluation of patients with nasopharyngeal carcinoma.