目的 分析MRI在评估调强放疗 联合多西他赛+奥沙利铂方案化疗治疗鼻 咽癌临床效果及预后中的价值。方法 回 顾性分析2013年6月-2015年6月我院收治 且经病理证实为鼻咽癌的50例患者的临 床资料，所有患者均接受调强放疗联合 多西他赛+奥沙利铂方案化疗，统计患者 放化疗前后MRI影像学资料，分析MRI在 评估鼻咽癌放疗及化疗疗效中的应用价 值。结果 50例患者共纳入178枚转移性 淋巴结，短径＜10mm者38枚，淋巴结面 积为(251.6±16.2)mm2，经放化疗后， 转移性淋巴结面积缩小，1月后复查131 枚淋巴结消失，残存47枚淋巴结，残存 淋巴结面积为(89.4±2.1)mm2，与治疗 前对比差异有统计学意义(P<0.05)； 治疗前肿瘤面积0.31-16.28cm2，平均 (5.15±3.21)cm 2，治疗后肿瘤面积 0-5.32cm2，平均(1.03±1.63)cm2，治疗 前后对比差异有统计学意义(P<0.05)。 50例鼻咽癌患者中，CR28例，PR18例， SD2例，NC2例，缓解率为92.00%。结论 MRI可准确反映鼻咽癌肿瘤形态特点及颈 部淋巴结转移情况，同时对鼻咽癌患者 生物学变化情况及肿瘤信号均有较高的 敏感性，可通过MRI观察肿瘤及淋巴结形 态、直径、边界的变化来评估其疗效， 临床应用价值高，值得推广。

Objective To analyze the clinical effect of MRI in the appraisal of intensitymodulated radiotherapy combined with docetaxel and oxaliplatin chemotherapy in the treatment of nasopharyngeal carcinoma and its value in prognosis. Methods The clinical data of 50 patients with pathologically confirmed nasopharyngeal carcinoma who were admitted into the hospital during June 2013 to June 2015 were retrospectively analyzed. All patients were treated with intensity-modulated radiotherapy combined with chemotherapy (docetaxel and oxaliplatin) scheme. The MRI imaging data of patients before and after radiotherapy combined with chemotherapy were statistically analyzed. The application value of MRI in the appraisal of the effect of radiotherapy and chemotherapy for nasopharyngeal carcinoma was analyzed. Results 50 patients were included in 178 metastatic lymph nodes. There were 38 short diameter of which was less than 10mm. The lymph node area was (251.6±16.2) mm2 . After radiotherapy and chemotherapy, the areas of metastatic lymph nodes reduced. The reexamination a month later showed that there were 131 lymph nodes disappearing and 47 lymph nodes remaining the area of which was (89.4±2.1) mm2 . Compared with that before the treatment, the difference was statistically significant (P<0.05). Before the treatment, the tumor size was 0.31 to 16.28cm2 and the average was (5.15±3.21) cm2 while after the treatment, was 0 to 5.32 cm2 and (1.03±1.63) cm2 , and the difference was statistically significant (P<0.05). Among the 50 patients with nasopharyngeal carcinoma, there were 28 cases of CR, 18 cases of PR, 2 cases of SD and 2 cases of NC. The remission rate was 92.00%. Conclusion MRI can accurately reflect the morphologic characteristics of nasopharyngeal carcinoma and the condition of cervical lymph node metastasis. Meanwhile, it is highly sensitive to biological changes and tumor signal in patients. The curative effect can be evaluated through the changes of form, diameter and boundary observed by MRI, which is worthy of promotion.