Objective: To investigate the value of quantitative dynamic contrast enhancement MR imaging (DCE-MRI) parameters in the prediction and evaluation of the response to neoadjuvant chemotherapy in patients with malignant sinonasal tumors by comparing the parameter values before and after chemotherapy. Methods: DCE-MRI was performed in 14 patients (6 male cases, 8 female cases, 16-83 years) with malignant sinonasal tumors before chemotherapy in Beijing Tongren Hospital from January 2012 to December 2013 in which DCE-MRI was performed in 8 patients on the 7th, 21st and 42nd days after chemotherapy. The values of quantitative parameter including K(trans), K(ep), and V(e) of the tumor were assessed and the change rate of these quantitative parameter values after chemotherapy was calculated. Results: Response to chemotherapy of the tumor was found in 11 patients with malignant sinonasal tumors,whereas no response to chemotherapy of the tumor was confirmed in 3 patients. K(trans) ((0.75±0.28)/min) and K(ep) ((3.23±1.48)/min) values of the tumor before chemotherapy in patients with response to chemotherapy were significantly bigger than those ((0.43±0.41)/min, (1.34±0.42)/min) in patients with no response to chemotherapy (all P<0.01).There was no significant difference in V(e) values between two groups (P=0.165). Compared with K(trans) values of the tumor before chemotherapy,the change rate of K(trans) values decreased more than 40% on the 7th,21st and 42nd days after chemotherapy in the patients with treatment response,whereas the change rate did not decrease significantly in the patients without treatment response. Conclusion: The bigger K(trans) and K(ep) values of the tumor before chemotherapy,the better the treatment response of the tumor to chemotherapy.
目的： 通过对鼻腔和鼻窦恶性肿瘤患者化疗前及化疗后不同时间点的动态增强磁共振成像（DCE-MRI）定量参数值的对比研究，初步探讨DCE-MRI定量参数值在预测和评估鼻腔和鼻窦恶性肿瘤新辅助化疗效果中的价值。 方法： 收集2012年1月至2013年12月在北京同仁医院住院行新辅助化疗的14例鼻腔和鼻窦恶性肿瘤在化疗前行鼻腔和鼻窦DCE-MRI检查的患者，男6例、女8例，年龄16~83岁，其中8例在化疗后第7、21和42天同时行鼻腔和鼻窦DCE-MRI检查，采用自编的后处理软件获得肿瘤的容积转移常数（K(trans)）、速率常数（K(ep)）、血管外细胞外间隙（V(e)）等定量参数值。对照实体瘤疗效评价标准（RECIST），比较分析化疗有效组和无效组肿瘤的K(trans)、K(ep)和V(e)值差异有无统计学意义，并计算在化疗不同时间点肿瘤的K(trans)、K(ep)和V(e)值的变化情况。 结果： 11例肿瘤对化疗有效，3例对化疗无效。化疗有效组肿瘤化疗前的K(trans)和K(ep)值[（0.75±0.28）/min、（3.23±1.48）/min]大于无效组[（0.43±0.41）/min、（1.34±0.42）/min）（均P<0.01），两组之间的V(e)值差异无统计学意义（P=0.165）。与化疗前比较，化疗有效组化疗后第7、21和42天肿瘤K(trans)值平均变化率较大，降低程度超过了40%，化疗后第7天变化率的斜率最大；化疗无效组患者化疗后第7、21和42天肿瘤K(trans)值平均变化率较小，第7天和42天基本上无变化，而第21天K(trans)值反而升高。 结论： 肿瘤化疗前的K(trans)和K(ep)值越大，化疗效果越好。化疗后早期K(trans)值降低越明显化疗效果越好。.
Keywords: Dynamic contrast enhancement; Magnetic resonance imaging; Paranasal sinus neoplasms; Quantitative diagnosis.