摘要
目的:探讨MRI动态增强扫描TIC评估骨肉瘤新辅助化疗疗效的临床价值。方法:回顾性分析经手术病理证实的骨肉瘤患者24例,均于实施新辅助化疗前和化疗4个周期后行DCE-MRI检查。通过后处理软件观察骨肉瘤新辅助化疗前后肿瘤的强化形态和TIC类型。根据病理肿瘤坏死率(TNR)分级法,分为反应良好组(TNR≥90%)和无反应组(TNR<90%)。采取Fisher精确检验比较2组间化疗前后及2组组内化疗前后TIC类型分布差异。结果:反应不良组共12例,化疗前TIC以Ⅱ、Ⅲ型(33.3%、58.3%)为主,化疗后仍以Ⅱ、Ⅲ型(41.7%、33.3%)居多,化疗前后TIC分布差异无统计学意义(P=0.570);反应良好组共12例,化疗前TIC以Ⅱ型(66.7%)为主,化疗后以Ⅰ型(83.3%)为主,化疗前后TIC分布差异有统计学意义(P=0.002)。2组间化疗前TIC分布差异无统计学意义(P=0.103),而化疗后TIC分布差异有统计学意义(P=0.024)。结论:MRI动态增强扫描的TIC类型可评估骨肉瘤新辅助化疗疗效,Ⅰ型曲线反映新辅助化疗疗效显著。
Objective:To explore the value of TIC morphology in evaluating neoadjuvant chemotherapeutic efficacy of osteosarcoma by DCE-MRI.Methods:Data of 24 cases of osteosarcoma confirmed by surgery and pathology were retrospectively analyzed,all patients underwent DCE-MRI before neoadjuvant chemotherapy and after 4 cycles of chemotherapy.Enhanced morphology and TIC types of osteosarcoma before and after neoadjuvant chemotherapy were observed by post-processing software.According to Huvos grading method in the pathological tumor necrosis rate(TNR),patients were divided into good response group(TNR≥90%)and non-response group(TNR<90%).The distribution of TIC types before and after chemotherapy between and in the two groups by Fisher accurate test.Results:24 patients were divided into good response group(n=12)and non-response group(n=12).The distribution of TIC typeⅠ,Ⅱ,Ⅲwere 1(8.3%),4(33.3%),7(58.3%)cases before chemotherapy,and changed to 4(12.5%),5(41.7%),3(25.0%)cases after chemotherapy in non-response group.The distribution of TIC was no significant difference before and after chemotherapy(P=0.570).Before chemotherapy,the distribution of TIC typeⅠ,ⅡandⅢwere 2(17.7%),8(66.7%),2(17.7%)cases in good response group,but after chemotherapy was 10(83.3%),1(8.3%),1(8.3%)case of TIC typeⅠ,Ⅱ,Ⅲ,respectively.The distribution of TIC was significantly different before and after chemotherapy(P=0.002).There was no significant difference in the distribution of TIC between the two groups before chemotherapy(P=0.103),but statistically significant after chemotherapy(P=0.024).Conclusion:DCE-MRI TIC type could be used to evaluate neoadjuvant chemotherapy response of osteosarcoma,the good effect of neoadjuvant chemotherapy reflected by typeⅠcurve is remarkable.
作者
曾燕妮
张卜天
王娟婷
袁强
谭敏仪
严宗伟
Zeng Yanni;Zhang Botian;Wang Juanting;Yuan Qiang;Tan Minyi;Yan Zongwei(China-Japan Union Hospital of Jilin University,Changchun,130033,China)
出处
《中国中西医结合影像学杂志》
2019年第3期252-255,共4页
Chinese Imaging Journal of Integrated Traditional and Western Medicine
基金
2018年花都区医疗卫生一般科研专项项目(18-HD WS-024)
关键词
磁共振成像
骨肉瘤
化学疗法
辅助
Magnetic resonance imaging
Osteosarcoma
Chemotherapy,adjuvant
