摘要
目的:探讨ADC值升高程度评估直肠癌放化疗后降期与否的可行性。方法:60例直肠癌患者根据术前磁共振检查结果和术后病理诊断分为T-降期组(T分期降低)和T-未降期组(T分期不变或升高),记录并分析放化疗治疗前、放化疗后第7天、第14天以及手术前直肠癌患者的ADC值。结果:两组ADC值均呈现出先升高后降低的变化趋势,差异均有统计学意义(P<0.05)。其中T-降期组放化疗后第7天ADC值较放化疗前显著增高,差异有统计学意义(t=1.293,P=0.000)。两组患者的ADC值在同一时间监测点的差异近似,差异不具有统计学意义(P>0.05)。以放化疗后第7天直肠癌患者平均ADC值的变化幅度作为判定是否降期的标准,以ADC值增高幅度≥18.6%为标准时,判定患者对放化疗敏感的敏感度为60.7%,特异度为100%,ROC曲线下面积为0.823。结论:扩散加权成像ADC值用于评估直肠癌患者对放化疗是否敏感及放化疗后降期与否具有一定价值。
Objective：To explore the feasibility of the ADC value for assessing down-staging after chemoradiation in patients with rectal carcinoma. Methods： Sixty patients with rectal carcinoma were divided into T-downstaged group and T- non--downstaged group according to preoperative MRI findings and postoperative pathological diagnosis. The ADC values prior to chemoradiation,7 days after chemoradiation, 14 days after chemoradiation and time before surgery were recorded and analyzed. Results： ADC values of both the two groups showed first increasing then decreasing trend. The difference was statistically significant （P〈0.05）. The ADC value of the T-downstaged group increased significantly 7 days after ehemora- diation compared to the value before chemoradiation. The difference was statistically significant （t= 1. 293, P = 0. 000）. The differences of ADC values between the two groups at same time point were similar, which were not statistically significant （P〉0.05）. The increase of ADC value seven days after chemoradiation was set as a standard to determine whether down- staging occurred or not in patients with rectal carcinoma. When the increased amplitude ≥18. 6%, the sensitivity was 60.7 % and specificity was 100%. Conclusion：It is valuable to the assessment of the response to chemoradiation by using ADC value of diffusion-weighted imaging in rectal carcinoma.
出处
《放射学实践》
2014年第5期556-559,共4页
Radiologic Practice
关键词
直肠肿瘤
放化疗
磁共振成像
扩散加权成像
Rectal neoplasms
Chemoradiotherapy
Magnetic resonance imaging
Di{fusion weighted imaging
