摘要
目的 探讨体素内不相干运动（IVIM）在食管鳞癌新辅助化疗疗效评估及预测中的价值.方法 前瞻性收集2015年9月至2017年3月经临床及病理证实为食管鳞状细胞癌的47例患者.所有患者均于新辅助化疗前及化疗结束后行MRI常规扫描及IVIM检查,并测量肿瘤的标准ADC、扩散系数（D）、灌注系数（D＊）及灌注分数（f）值.依据实体瘤疗效评价标准（RECIST）1.1版本将患者分为完全缓解（CR）、部分缓解（PR）、稳定（SD）和进展（PD）.化疗后又行手术的患者31例,依据病理标本肿瘤退缩分级（TRG）分为TRG 0～3级,分别为完全缓解、中度缓解、轻度缓解和未缓解.采用配对t检验和独立样本t检验（正态分布）,以及Wilcoxon秩和检验（非正态分布）比较新辅助化疗前与化疗后以及不同疗效的患者间各参数值的差异.差异有统计学意义的参数采用ROC曲线下面积评价参数的诊断效能.结果 47例患者新辅助化疗前后标准ADC值分别为（1.97±0.51）×10-3、（2.42±0.52）×10-3 mm2/s,D值分别为（1.30±0.30）×10-3、（1.63±0.35）×10-3 mm2/s,新辅助化疗后标准ADC值及D值较化疗前明显升高,差异均有统计学意义（t值分别为-6.35、-5.25,P值均〈0.01）,D＊、f值化疗前后差异无统计学意义（P〉0.05）.新辅助化疗后部分缓解者29例,稳定者18例,无完全缓解和进展的患者.化疗前部分缓解患者标准ADC、D、f值均明显低于稳定患者（t值分别为-3.11、-2.53、-2.10,P值均〈0.05）,化疗后部分缓解与稳定患者间各IVIM参数值的差异均无统计学意义.新辅助化疗后又行手术的31例患者中,TRG 2级14例,TRG 3级17例,无TRG 0、1级的患者.化疗前TRG 2与TRG 3级患者间各IVIM参数值的差异均无统计学意义,化疗后TRG 2级和3级患者的D值分别为（1.81±0.31）×10-3、（1.46±0.39）×10-3 mm2/s,差异有统计学意义（t=2.76,P〈0.05）.以D=1.68×10-3 mm2/s评价新辅助�
Objective To assess intravoxel incoherent motion（IVIM） in evaluating and predicting response to neoadjuvant ehemotherapy（NAC） in esophageal squamous cell earcinoma（ESCC）. Methods Forty-seven patients with ESCC diagnosed by pathological findings on biopsy from September 2015 to March 2017 were prospectively collected. All patients were examined before and after NAC using routine MRI scan and [VIM, The standard apparent diffusion coefficient （ADC）, diffusion coefficient （D）, perfusion coefficient （D＊） and perfusion score （f） were measured. The patients were divided into complete response （CR）, partial response （PR）, stable disease （SD） and progressive disease （PD） according to the 1.1 version of the response evaluation criteria in solid tumors （RECIST）. Thirty-one patients underwent surgery after NAC, and the patients were divided into TRG 0-3 according to tumor regression grade （TRG）. The differences of parameter values before and after NAC between different groups were analyzed using Student＇s t test （nomlal distribution） and Wilcoxon rank sum tests （non-normal distribution）. The parameters with statistical significance were evaluated by the receiver operating characteristics （ROC） curves. Results The ADC values before and after NAC were （1.97±0.51）× 10-3, （2.42±0.52）× 10-3 mm2/s. The D values before and after NAC were （1.30 ± 0.30） × 10^-3, （1.63 ± 0.35）× 10^-3 mm2 / s. The ADC and D values after NAC were significantly higher than those before NAC, and the differenees were statistieally significant （t=- 6.35, - 5.25 respectively, both P〈0.01）. There were no statistical differences on D and f between before and after NAC （P〉0.05）. The patients were divided into PR group （29 cases） and SD group （18 cases） after NAC, without CR and PD patients. The ADC, D and f values of PR group were significantly lower than those of the SD group before NAC （t= - 3.11, - 2.53 and - 2.10 respectively, all P〈0.05）. T
作者
宋涛
张宏凯
黎海亮
秦建军
冯稳
赵妍
曲金荣
Song Tao;Zhang Hongkai;Li Hailiang;Qin Jianjun;Feng Wen;Zhao Yan;Qu Jinrong(Department of Radiology,Affiliated Cancer Hospital of Zhengzhou University,Henan Cancer Hospital,Zhengzhou 450008,Chin)
出处
《中华放射学杂志》
CAS
CSCD
北大核心
2018年第8期581-586,共6页
Chinese Journal of Radiology
关键词
食管肿瘤
磁共振成像
体素内不相干运动
新辅助化疗
Esophageal neoplasms
Magnetic resonance imaging
Intravoxel incoherent motion
Neoadjuvant chemotherapy
