鼻咽癌颅底骨侵犯的零回波时间磁共振成像诊断价值

doi:10.19401/j.cnki.1007-3639.2025.10.007

摘要/Abstract

摘要：

背景与目的：鼻咽癌颅底骨侵犯的常规评估依赖CT，但CT的电离辐射存在潜在危害。零回波时间磁共振成像（zero echo time magnetic resonance imaging，ZTE-MRI）可在无辐射条件下获得高分辨率骨结构信息。本研究旨在系统评价ZTE-MRI对鼻咽癌颅底骨侵犯的诊断效能，并探讨其临床替代CT的可行性。方法：本前瞻性研究收集2020年4月—2022年12月在福建省肿瘤医院诊治的鼻咽癌患者95例为起始对象，并根据排除标准进行剔除。运用GE Discovery 750w 3.0T MR扫描仪，获取常规平扫、增强扫描，利用ZTE-MRI技术获取ZTE-MRI和CT图像。影像检查结果由两位放射科医师分别独立阅片评估颅底骨侵犯情况。本研究经福建省肿瘤医院伦理委员会批准（K2025-314-01）并获得患者知情同意。结果：共计80例鼻咽癌患者纳入最终分析。CT诊断鼻咽癌颅底骨侵犯与参比标准有高度一致性，差异有统计学意义（κ=0.645，P<0.001）。ZTE-MRI诊断鼻咽癌颅底骨侵犯与参比标准亦有高度一致性，差异有统计学意义（κ=0.774，P<0.001）。ZTE-MRI联合常规MRI诊断鼻咽癌颅底骨侵犯与参比标准具有极强一致性，差异有统计学意义（κ=0.912，P<0.001）。结论：ZTE-MRI技术为鼻咽癌颅底骨侵犯提供“类CT”图像，在临床上ZTE-MRI技术可以替代CT检查。

关键词: 鼻咽癌, 颅底, CT, MRI, 零回波时间

Abstract:

Background and purpose: Owing to the reliance on computed tomography (CT) for evaluating skull-base bone invasion in nasopharyngeal carcinoma and the potential harm of ionizing radiation from CT, zero echo time magnetic resonance imaging (ZTE-MRI) offers high-resolution bone delineation without radiation exposure. Therefore, this study aimed to systematically assess the diagnostic performance of ZTE-MRI for detecting skull-base bone invasion and to explore its clinical feasibility as an alternative to CT. Methods: This prospective study collected 95 nasopharyngeal carcinoma patients treated in Fujian Provincial Cancer Hospital from April 2020 to December 2022 as the research subjects. The patients who do not meet the inclusion standards would be excluded. Using the GE Discovery 750W 3.0T MR scanner to obtain unenhanced scan and enhanced scan, using ZTE-MRI technology to obtain ZTE-MRI and CT image. The results of the imaging scans were used to independently assess skull base bone invasion by two radiologists. This study was approved by the Ethics Committee of Fujian Cancer Hospital (K2025-314-01), and informed consent from the patients were obtained. Results: A total of 80 nasopharyngeal carcinoma patients were included in the final analysis. There was a high degree of consistency between CT diagnosis of nasopharyngeal carcinoma skull base bone invasion and of gold standards, and the difference was statistically significant (κ=0.645, P<0.001). There was a high degree of consistency between ZTE-MRI diagnosis of nasopharyngeal carcinoma skull base bone invasion and of gold standards, and the difference was statistically significant (κ=0.774, P<0.001). There was a high degree of consistency between ZTE-MRI combined with conventional MRI diagnosis of nasopharyngeal carcinoma skull base bone invasion and gold standards, and the difference was statistically significant (κ=0.912, P<0.001). Conclusion: ZTE-MRI technology provides "like CT" images for the skull base bone invasion in nasopharyngeal carcinoma, and ZTE-MRI technology can replace CT examination in clinical practice.

Key words: Nasopharyngeal carcinoma, Skull base, Computed tomography, Magnetic resonance imaging, Zero echo time

中图分类号:

R739.62

林家豪, 冯妹妹, 林孔起, 林冯杰, 陈韵彬. 鼻咽癌颅底骨侵犯的零回波时间磁共振成像诊断价值[J]. 中国癌症杂志, 2025, 35(10): 946-951.

LIN Jiahao, FENG Meimei, LIN Kongqi, LIN Fengjie, CHEN Yunbin. The diagnostic value of zero echo time magnetic resonance imaging for skull base bone invasion in nasopharyngeal carcinoma[J]. China Oncology, 2025, 35(10): 946-951.

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ZTE-MRI	Standard imaging diagnosis n		Total n	κ value	P value
ZTE-MRI	(+)	(-)	Total n	κ value	P value
(+)	50	1	51	0.774	0.001
(-)	7	22	29	0.774	0.001
Total	57	23	80

ZTE-MRI combined with conventional MRI	Standard imaging diagnosis n		Total n	κ value	P value
ZTE-MRI combined with conventional MRI	(+)	(-)	Total n	κ value	P value
(+)	54	0	54	0.912	0.001
(-)	3	23	26	0.912	0.001
Total	57	23	80