目的 探讨MRI在评估奈达铂 (NDP)联合氟尿嘧啶(5-FU)诱导化疗治疗 局部晚期鼻咽癌中的应用价值。方法 收 集我院2014年5月-2016年5月收治的晚期 鼻咽癌患者60例，所有患者均行奈达铂联 合氟尿嘧啶诱导化疗治疗，于治疗前后进 行MRI检查，计算治疗后总有效率，并比 较复发和纤维化患者MRI曲线斜率。结果 化疗后肿瘤面积较化疗前明显缩小，边界 较前清晰，T1W1低信号、T2W1高信号、 DWI低信号，DCE-MRI扫描呈不均匀强化； CR 31例、PR 24例、SD 2例、PD 3例， 有效率=91.67%；化疗前肿瘤平均面积为 (5.23±3.42)cm2 ；化疗前肿瘤平均面积 为(1.25±1.67)cm2 ，化疗后的肿瘤消退 率=76.11%；随访半年后，复发有13例， 纤维化47例，DCE-MRI扫描显示，复发组 斜率为(19.23±9.27)，纤维化组斜率为 (4.53±1.57)，纤维化组的斜率明显低于 复发组，差异具有统计学意义(t=10.32， P＜0.05)。结论 MRI可以清晰显示肿瘤的 大小、形态、边界，对鼻咽癌患者肿瘤信 号和生物学变化情况具有较高的敏感性， 对化疗后疗效的评估和复发与纤维化组织 的鉴别均具有重要的应用价值。

Objective To explore the application value of MRI in the evaluation of nedaplatin combined with fluorouracil induction chemotherapy in the treatment of locally advanced nasopharyngeal carcinoma. Methods 60 patients with advanced nasopharyngeal carcinoma admitted in our hospital from May 2014 to May 2016 were selected for the study and treated with nedaplatin combined with fluorouracil induction chemotherapy. MRI examination was performed before and after treatment. The total effective rate after treatment was calculated and the slopes of the MRI curve were compared between the patients with recurrence and fibrosis. Results After chemotherapy, the tumor area was significantly smaller than that before chemotherapy and the boundary was clearer than before. What's more, low signal in T1W1, high signal in T2W1, low signal in DWI and uneven enhancement shown in the DCE-MRI scan were expressed after chemotherapy. There were 31 cases of CR, 24 cases of PR, 2 cases of SD, 3 cases of PD and the effective rate was 91.67%. The average area of tumor was (5.23±3.42)cm2 before chemotherapy and (1.25±1.67)cm2 after chemotherapy, and the tumor regression rate after chemotherapy was 76.11%. After half a year follow-up, there were 13 cases of recurrence and 47 cases of fibrosis. And the slope was (19.23±9.27) in the recurrence group and (4.53±1.57) in the fibrosis group shown by the DCE-MRI scan, and the slope of the fibrosis group was significantly lower than that of the recurrence group, therefore the difference was statistically significant(t=10.32, P<0.05). Conclusion MRI can clearly show the tumor size, shape and border, and has a high sensitivity to the tumor signals and biological changes in patients with nasopharyngeal carcinoma, and has important application values in the efficacy evaluation after chemotherapy and the identification of recurrence and fibrosis tissues.