摘要
背景与目的磁共振扩散加权成像(di usion-weighted imaging,DWI)能够在体检测水分子微观运动,对肿瘤治疗后微环境变化较为敏感。本研究旨在探讨DWI在监测、预测肺癌化疗效果中的应用价值。方法对19例经病理确诊并接受化疗的肺癌患者,于化疗前一周和化疗开始后一个月分别行磁共振成像(magnetic resonanceimaging,MRI)常规平扫及DWI检查。于横轴位T2加权像(T2weighted imaging,T2WI)上测量肿瘤最大径(长径)、最大垂直径(短径)及长、短径平均值(平均径),并据此将肿瘤对化疗的反应分为完全反应(complete response,CR)、部分反应(partial response,PR)、稳定病变(stable disease,SD)和进展病变(progressive disease,PD)共四个疗效组。于DWI图象上测量化疗前和化疗后表观扩散系数(apparent di usion coe cient,ADC)值,用t检验分析化疗前后ADC值及各疗效组化疗前ADC的差异。用Pearson相关系数分析化疗前后ADC值的变化率、化疗前ADC值与肿瘤各径线变化率之间的相关性。结果与化疗前相比,肿瘤化疗后ADC值显著升高(1.482±0.456vs1.675±0.485,P=0.004)。化疗前后ADC变化率与其长径、短径及平均径的变化率呈正相关(r=0.635,r=0.612,r=0.539,P<0.05)。PR组、SD组化疗前ADC值与其长径变化率呈负相关(r=-0.806,r=-0.632,P<0.05)。结论 ADC值的变化能较敏感地反映肺癌化疗后的早期改变,结合形态学测量,有助于早期、动态监测化疗疗效。
Background and objective DWI-MRI could detect the microscopic motion of water molecules which is sensitive to microcirculation change of many kinds of tumors a er therapy.e aim of this study is to investigate the value of di usion-weighted imaging（DWI） in monitoring and predicting lung cancer response to chemotherapy.Methods Nineteen patients pathologically diagnosed as lung cancer were included in this study,all of whom received both conventional MRI and DWI examinations one week before and one month a er the initiation of chemotherapy.e response of lung cancers to therapy were classi ed into four groups：complete response（CR） ,partial response（PR） ,stable disease（SD） ,and progressive disease（PD） based on the change of lesion diameter measured on axial T2-weighted MR imaging.Apparent di usion coefcients（ADCs） were measured for each lesion at pre-and post-chemotherapy and were compared with t-test.e correlations between the percentage changes of ADCs and the percentage changes of diameters（long,short,and mean） were further evaluated with Pearson correlation coe cient,as well as that between pre-chemotherapy ADCs and the percentage changes of diameters.Results e mean pre-chemotherapy ADCs was signi cantly higher than that of the post-chemotherapy ADCs（1.482± 0.456 vs 1.675±0.485,P=0.004） .A positive correlation was found between the percentage changes of ADCs and the percentage changes of the long,short,and the mean diameter,respectively（r=0.635,r=0.612,r=0.539,P0.05） .A negative correlation was found between pre-chemotherapy ADCs and the percentage change of the long diameter a er chemotherapy in PR and SD group（r=-0.806,r=-0.632,P0.05） .Conclusion e change of ADCs can sensitively re ect the early change of lung cancer response to chemotherapy and has the potential ability to dynamically monitor the lung cancer response to chemotherapy combined with the morphological measurement.
出处
《中国肺癌杂志》
CAS
2011年第3期256-260,共5页
Chinese Journal of Lung Cancer
关键词
肺肿瘤
磁共振扩散加权成像
表观扩散系数
化疗
Lung neoplasms
Diffusion-weighted imaging
Apparent diffusion coefficient
Chemotherapy
