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目的：探讨鼻咽癌放疗后局部复发和纤维变的螺旋ＣＴ动态增强特征。材料与方法：放疗后纤维变组（ＲＦ组）５０例，放疗后复发组（ＲＮＰＣ组）４６例，先平扫，然后选择“兴趣区”行同层动态增强扫描。采用ＥＬＳＣＩＮＴＣＴ－ＦＬＡＳＨ双螺旋ＣＴ扫描机，自动压力注射器注药。分别测量平扫与增强后不同时刻的ＣＴ值，进行统计学处理并描绘密度－时间曲线。结果：１．ＲＦ组于增强后２１０秒时达峰值，其动态增强曲线形态特征呈一“缓升－缓降”型。２．ＲＮＰＣ组于增强后１５０秒时达峰值，其动态增强曲线特征呈一“速升－缓升－缓降”型。３．注射造影剂后４０秒至３００秒期间，ＲＦ组与ＲＮＰＣ组间各对应时刻点ＣＴ值均数均有显著性差异（Ｐ＜０．００１）。ＲＮＰＣ组明显高于ＲＦ组。结论：ＲＦ与ＲＮＰＣ的螺旋ＣＴ动态增强曲线特征及病变区ＣＴ值的明显差异可作为两者鉴别诊断的重要依据。
Objective: To investigate the dynamic enhancement characteristics of spiral CT in the local recurrence and fibrosis of nasopharyngeal carcinoma after radiotherapy. MATERIALS AND METHODS: Fifty cases of fibrosis group (RF group) and 46 cases of post-radiotherapy group (RNPC group) were treated with radiofrequency catheter ablation, followed by plain scan. Using ELSCINTCT-FLASH double helical CT scanner, automatic pressure syringe injection. The values of CT at different time after plain scan and post-scan were measured respectively, and the statistics were processed and the density-time curve was plotted. Results: 1. RF group peaked at 210 seconds after enhancement, and its dynamic enhancement curve showed a “gentle-slowed-down” pattern. 2. The RNPC group peaked at 150 seconds after enhancement, and its dynamic enhancement curve showed a “rapid rise - slow rise - slow decrease”. 3. Between 40 seconds and 300 seconds after injection of contrast agent, there was a significant difference (P <0.001) in mean CT values between RF group and RNPC group at corresponding time points. RNPC group was significantly higher than the RF group. Conclusion: The significant difference between the dynamic enhancement curve characteristics of spiral CT and the CT value of the lesion area between RF and RNPC can be used as an important basis for the differential diagnosis between the two.