摘要
目的骨肉瘤患者新辅助化疗(neoadjuvant chemotherapy,NAC)疗效评估对于术后化疗方案的制定及预后判断具有重要意义。本研究观察磁共振扩散加权成像(diffusion-weighted imaging,DWI)表观扩散系数(apparent diffusion coefficient,ADC)在骨肉瘤NAC前后的变化,探讨平均ADC值(ADCmean)和最小ADC值(ADCmin)在骨肉瘤NAC疗效评估中的价值。方法对云南省肿瘤医院2013-06-01-2015-05-30 17例原发性骨肉瘤患者在NAC前、后进行常规MR及DWI检查。测量化疗前、后肿瘤ADCmean、ADCmin,并计算ADCmean变化率和ADCmin变化率,计算公式为ADC变化率=(ADC化疗后-ADC化疗前)/ADC化疗前。术后肿瘤坏死率评估按Huvos标准分为化疗反应良好组和反应差组。用配对样本t检验比较化疗前后ADCmean和ADCmin,化疗反应不同组间ADCmean变化率和ADCmin变化率。结果化疗反应良好组10例,反应差组7例。骨肉瘤NAC后ADCmean和ADCmin分别为(1.60±0.32)×10-3和(1.27±0.35)×10-3 mm2/s,较化疗前〔(1.09±0.28)×10-3和(0.79±0.12)×10-3 mm2/s〕明显升高,差异均有统计学意义,P<0.001。化疗反应良好组ADCmin变化率为1.09±0.18,明显高于反应差组的0.55±0.29,P<0.05;但2组间ADCmean变化率差异无统计学意义,P=0.088。结论 DWI可以通过NAC前后ADC值的变化来监测骨肉瘤化疗疗效,ADCmin是骨肉瘤患者有用的预后指标。
OBJECTIVE Evaluation of neoadjuvant chemotherapy in patients with osteosarcoma has great significance for the development of postoperative chemotherapy and prognosis. The aim of this study was to investigate the change of apparent diffusion coefficient （ADC） of diffusion-weighted imaging （DWI） before and after neoadjuvant chemotherapy （NAC） in osteosarcoma and to explore the value of the average ADC and the minimum ADC for assessing the response to NAC. METHODS From June 1,2013 to May 30,2015,Magnetic resonance imaging （MRI） and DWI were obtained from 17 patients before and after neoadjuvant chemotherapy from Tumor Hospital of Yunnan Province. The pre- and post-chemotherapy values were measured in both the average and minimum ADC. Additionally, the ADC ratios （[AD- Cpost-ADCpre]/ADCpre） were calculated using the average ADC and the minimum ADC. The pre-chemotherapy values of the average ADC and minimum ADC were compared with the post-chemotherapy values respectively. Totally 17 patients with osteosarcoma were divided into two groups, those with a good response to chemotherapy and those with a poor response using Huvos classification by the degree of tumor necrosis. The average ADC ratio and the minimum ADC ratio of the two groups were compared. T-test was performed for testing changes in ADC value between the two groups. RESULTS There were ten cases with a good response to chemotherapy and seven cases with poor response. For both the average and the minimum ADC, post-chemotherapy values were significantly higher than pre-chemotherapy values, （1.60＋-0.32） × 10-3 mm2/s and （1.27＋-0.35） × 10-3 mm2/s versus （1.09＋-0.28） × 10-3 mm2/s and （0.79＋-0.12） × 10-3 mm2/s respectively （P〈0. 001）. The patients with a good response had a significantly higher minimum ADC ratio than those with a poor response （1.09＋-0.18 and 0.55＋-0.29 respectively,P〈0. 05）. But for the average ADC ratio,nosignificant difference was observed between the two groups （P=0. 088）. CONC
出处
《中华肿瘤防治杂志》
CAS
北大核心
2016年第16期1095-1098,共4页
Chinese Journal of Cancer Prevention and Treatment
关键词
骨肉瘤
药物疗法
扩散加权成像
磁共振成像
osteosarcoma
chemotherapy
diffusion-weighted imaging
magnetic resonance imaging
