磁共振扩散加权成像早期预测肺癌化疗疗效的价值.pdf

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1、丝堂实践2014年8月第29卷第8期RadiolPractice，Aug2014，Vol29，No．8929胸部影像学磁共振扩散加权成像早期预测肺癌化疗疗效的价值蒋洁智，李鸡，李卓琳，丁莹莹【摘要】目的：评价磁共振扩散加权成像(DWI)对肺癌化疗疗效的早期预测价值。方法：对3O例经病理证实的肺癌患者，在化疗前及第一周期化疗后进行MRI检查，包括常规TwI，TwI及DWI检查。根据第二周期化疗后肿瘤最大径退缩率，按RECIST标准将患者分为治疗有效组和无效组，比较两组中肿瘤的表观扩散系数(ADC值)和最

2、大径的差异，分析ADC值变化率的受试者工作特征曲线(ROc)，获得预测治疗有效的ADC值变化率临界值(cut—offvalue)。结果：第一周期化疗后，有效组化疗前后病灶的平均ADC值的差异有统计学意义(P值d0．001)；有效组和无效组中肿瘤ADC值的差异有统计学意义(P一0．031)；肿瘤最大径在两组间的差异无统计学意义(P一0．210)。以ADC值升高8．5作为ADC值变化率诊断分界点，预测治疗获得PR的敏感度为85．7，特异度为72．9。结论：ADC值可以对肺癌化疗疗效进行早期监测。【关键词】

3、肺癌；扩散加权成像；磁共振成像；化学治疗【中图分类号】R445．2；R734．2【文献标识码】A【文章编号】1000—0313(2014)08—0929—04D0I：10．13609／．cnki．1000—0313．2O14．08．022ValueofdiffusionweightedMRimaginginearlypredictionofchemotherapyeffectforlungcancerJIANGJie—zhi，LIKun，LIZulin，eta1．DepartmentofRadiolo

4、gy，theThirdAffilitedHospitalofKunmingMedicalUniversity，Kunming650018，P．R．China[Abstract]Objective：ToassessthevalueofdiffusionweightedMRimaging(DWI)inearlypredictionofchemothera—PYeffectforlungcancer．Methods：Theprospectivestudyincluded30patientswithlungc

5、ancerundergoingchemotherapy．MRIexaminationswereperformedbeforechemotherapy(thefirsttimepoint)andafterthefirstcycleofchemotherapy(thesecondtimepoint)，withconventionalTlWI，T2WIandDWI．OnthebasisofRECISTstandard，allpatientsweredividedin—torespondingandnon—‘

6、respondinggroupbasedontumormaximumdiametershrinkagerateafterthesecondcycleofehemo—therapy．ADCvalueofthetumorandthetumormaximumdiameterbetweenthetwogroupswerecompared．Thecut—offvalueofADCforrespondingpredictionwasevaluatedbyanalyzingtheROCcurveofthechang

7、erateofADC．Results：Afterfirstcycleofchemotherapy，therewasstatisticalsignificantdifferenceofmeanADCvaluebetweentumorsofpretherapygroupandposttherapygroupinrespondinggroup(P<0．001)．TherewasalsostatisticalsignificantdifferenceofADCvalueoftumorsbetweenrespo

8、ndinggroupandnon—respondinggroup(P一0．031)．Thesewasnosignificantdifferenceoftumormaximumdiameterinbothgroups(P=0．210)．WhentheADCvalueincreased8．5beingsetascutoffpointforthepredictionofresponding(includingpartialandcompleteresponse