磁共振技术评价头颈部肿瘤放疗后涎腺功能的应

研究进展

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磁共振技术评价头颈部肿瘤放疗后

涎腺功能的应用及进展

　　［摘要］　口干是头颈部肿瘤放疗后最常见且最突出的晚期反应之一，当前各种检测涎腺功能的手段都有一定的不足。磁共振涎管成像(magnetic resonance sialography, MRS)和扩散加权磁共振成像(diffusion-weighted magnetic resonance imaging, DW MRI)是近年新发展起来的涎腺功能评价方法，具有无创、无辐射的特点。本文就该技术在涎腺功能评价方面的应用进展作一综述，为探讨头颈部肿瘤患者放疗前后涎腺功能变化监测手段的发展方向提供参考。

　　［关键词］　磁共振涎管成像；　扩散加权磁共振成像；　口腔干燥；　放疗后涎腺功能　　中图分类号：R730.42；R739.91　　文献标识码：A　　文章编号：1007-3639(2009)11-0875-06

Advance in MR imaging for evaluation of postradiotherapy salivary function in patients with head and neck cancer　OU Dan,HE Xia-yun (Department of Radiation Oncology, Cancer Hospital, Fudan University,Department of Oncology,Shanghai Medical College, Fudan University, Shanghai 200032, China)

Correspondence to：HE Xia-yun　E-mail：hexiayun1120@

　　［Abstract］ Salivary gland damage with subsequent xerostomia has been an unavoidable complication in most head and neck cancer patients after radiotherapy. However, there were many shortcomings of each current detecting technique. Magnetic resonance sialography (MRS) and diffusion-weighted magnetic resonance imaging (DW MRI), as two of the most important progresses in the latest MRI techniques, with the virtue of non-invasion and non-ionizing radiation, has been rapidly developed in salivary function assessment in recent years, and it has kept on improving technically. This article mainly reviewed the clinical applications and research advances of these two MRI technologies in post-radiotherapy salivary function assessment in patients with head and neck cancers, so as to provide reference for further study.

　［Key words］　magnetic resonance sialography; diffusion-weighted magnetic resonance imaging; xerostomia; postradiotherapy salivary function

　　在头颈部肿瘤尤其是鼻咽癌的治疗中，放射治疗扮演着重要的角色。鼻咽癌患者Ⅰ、Ⅱ、Ⅲ和Ⅳ期治疗后5年生存率分别为>90%、>70%、50%及30%［1-4］。随着生存期的延长，患者对生活质量也有了更高的要求。口干是头颈部肿瘤放疗后最常见且最突出的晚期反应之一。由于放疗照射野部分或全部包括涎腺［5］，患者放疗后涎腺功能会有不同程度的损伤，会出现口腔干燥、味觉障碍、龋齿、吞咽困难和咳嗽等症状。随后其症状迁延并呈进行性加重而无有效控制方法，致睡眠障碍、心情压抑、烦躁易怒，严重影响患者的生活质量［6-9］。因

通讯作者：何霞云　E-mail:hexiayun1120@

此在对头颈部肿瘤实行局部放疗的同时尽可能减少对涎腺的损伤就显得十分重要，如何合理而有效地评价涎腺功能也日益引起关注。

　　近年来，磁共振技术在涎腺功能评价中的应用虽仍处于初步探索阶段，但其价值和优势已逐步显现。磁共振涎管成像(magnetic resonance sialography, MRS)和扩散加权磁共振成像(dif-和扩散加权磁共振成像(dif-(dif-fusion-weighted magnetic resonance imaging, DW MRI)作为无创性检查手段，能提供更加快速、直观的图像及更具客观性的量化功能指标，本文就磁共振成像新技术对头颈部肿瘤放疗后涎腺功能评价的应用及研究进展作一综述。

1　放疗后造成口腔干燥的相关因素　涎腺由大