目的探析核磁共振成像(MRI)不 同扫描方式对鼻咽癌早期诊断的临床价 值。方法 收集2016年1月-2018年1月收治 的拟诊断为鼻咽癌的患者125例进行回顾 性分析。所有患者均进行动态增强成像 (DCE-MRI)和弥散加权成像(DWI)扫描，并 以穿刺活检病理结果为金标准，比较两种 检测方式对鼻咽癌的灵敏度、特异度和 准确度；将拟诊断为鼻咽癌患者根据MRI 的扫描方式不同分为动态增强成像(DCEMRI)组和弥散加权成像(DWI)组。分析两 种扫描方式对鼻炎癌患者和非鼻炎癌患者 的肿瘤的生物学差异；结果 DCE-MRI对早 期鼻咽癌诊断的灵敏度(0.969)、特异度 (0.667)、准确度(0.904)高于DWI(灵敏度 0.867，特异度0.630，准确度0.816)； DWI扫描结果表明，与非鼻咽癌患者的低 信号不同，鼻咽癌患者病灶的T2WI表现为 中等信号或高信号者居多(P<0.05)；且鼻 咽癌患者的ADC值明显低于非鼻咽癌患者 (P<0.05)；DCE-MRI扫描结果表明，鼻咽 癌患者的容量转移常数(Ktrans)、单位时间 内造影剂从细胞外间隙(EES)进入血管内 的量(Kep)及单位体积内EES的体积(Ve)均 明显高于非鼻咽癌患者(P<0.05)。结论 DCE-MRI扫描和DWI扫描均能对鼻炎癌早期 进行一定程度的影像学诊断，但DCE-MRI 对早期鼻咽癌患者诊断的灵敏度、特异度 和准确度更高。

Objective To analyze the clinical value of different magnetic resonance imaging (MRI) scanning methods in the early diagnosis of nasopharyngeal carcinoma. Methods 125 cases of patients diagnosed as nasopharyngeal carcinoma who were admitted between January 2016 and January 1818 were retrospectively analyzed. All patients were given dynamic enhanced imaging (DCE-MRI) and diffusion-weighted imaging (DWI) scans. The sensitivity, specificity and accuracy of the two detection methods for nasopharyngeal carcinoma were compared by taking pathological results of biopsy as gold standard. Patients diagnosed as nasopharyngeal carcinoma were divided into dynamic enhanced imaging (DCE-MRI) group and diffusion-weighted imaging (DWI) group according to different MRI scanning methods. The biological differences between the two scanning methods for tumors were analyzed in patients with nasopharyngeal carcinoma and patients without nasopharyngeal carcinoma. Results The sensitivity, specificity and accuracy of DCE-MRI with 0.969, 0.667 and 0.904 in the diagnosis of early nasopharyngeal carcinoma were higher than those of DWI with 0.867, 0.630 and 0.816. DWI scan results showed that different from the low signal of patients without pharyngeal carcinoma, the T2WI of patients with nasopharyngeal carcinoma showed moderate or high signal (P<0.05). The ADC value of patients with nasopharyngeal carcinoma was significantly lower than that of patients without nasopharyngeal carcinoma (P<0.05). The results of DCE-MRI scan showed that the volume transfer constant (Ktrans), Kep of contrast agent entering the blood vessels from the extracellular space (EES) per unit time, and the volume (Ve) of EES per unit volume in patients with nasopharyngeal carcinoma were significantly higher than those of patients without nasopharyngeal carcinoma (P<0.05). Conclusion Both DCE-MRI scan and DWI scan can have a certain degree of imaging diagnosis in the early nasopharyngeal carcinoma, but DCE-MRI has higher sensitivity, specificity and accuracy in the diagnosis of patients with early nasopharyngeal carcinoma.