目的观察动态增强磁共振(DCE-MRI)能否在术前判断直肠癌新辅助治疗的疗效,比较常规T2WI与DCE-MRI对直肠癌术前T、N分期的准确性。方法收集术前或术后病理确诊的直肠癌患者40例。其中行术前新辅助治疗者22例,未进行术前新辅助治疗者18例...目的观察动态增强磁共振(DCE-MRI)能否在术前判断直肠癌新辅助治疗的疗效,比较常规T2WI与DCE-MRI对直肠癌术前T、N分期的准确性。方法收集术前或术后病理确诊的直肠癌患者40例。其中行术前新辅助治疗者22例,未进行术前新辅助治疗者18例。所有患者均在GE1.5T Twinspeed HD MR扫描仪行盆腔动态增强扫描。扫描序列包括T2WI压脂、T1WI、DWI,快速三维容积T1加权脂肪抑制成像增强扫描(3DLAVA)。分析动态增强曲线的各项参数在新辅助治疗前后的变化,观察癌灶曲线上升速率。结果①对未进行术前治疗的直肠癌分期的准确性:DCE-MRI与常规T2WI对直肠癌T分期的准确性分别为83.3%和66.7%,对环周切缘阴性判断准确性为88.2%和70.6%。T2WI及DCE-MRI均能发现直径≥2mm的淋巴结。②对新辅助治疗后直肠癌再分期的准确性:DCE-MRI对T、N再分期的准确性可达86.4%和81.8%,对环周切缘情况判断准确性为100%。而T2WI进行T、N再分期较困难。③治疗前癌灶的曲线上升速率明显高于正常肠管;治疗后达病理完全缓解组原癌灶部略低于下段正常肠管,但是差异不明显;治疗后未达病理完全缓解组癌灶部仍高于下段正常肠管。结论DCE-MRI对术前直肠癌分期的准确性高,并能够准确判断新辅助治疗后癌周切缘情况。癌灶与参照肠管的上升速率比较有助于在术前判断疗效。展开更多
Local ablative techniques-percutaneous ethanol injection, microwave coagulation therapy and radiofrequency ablation (RFA)-have been developed to treat unresectable hepatocellular carcinoma (HCC). The success rate of p...Local ablative techniques-percutaneous ethanol injection, microwave coagulation therapy and radiofrequency ablation (RFA)-have been developed to treat unresectable hepatocellular carcinoma (HCC). The success rate of percutaneous ablation therapy for HCC depends on correct targeting of the tumor via an imaging technique. However, probe insertion often is not completely accurate for small HCC nodules, which are poorly def ined on conventional B-mode ultrasound (US) alone. Thus, multiple sessions of ablation therapy are frequently required in diffi cult cases. By means of two breakthroughs in US technology, harmonic imaging and the development of second-generation contrast agents, dynamic contrast-enhanced harmonic US imaging with an intravenous contrast agent can depict tumor vascularity sensitively and accurately, and is able to evaluate small hypervascular HCCs even when B-mode US cannot adequately characterize the tumors. Therefore, dynamic contrast-enhanced US can facilitate RFA electrode placement in hypervascular HCC, which is poorly depicted by B-mode US. The use of dynamic contrast-enhanced US guidance in ablation therapy for liver cancer is an effi cient approach. Here, we present an overview of the current status of dynamic contrast-enhanced US-guided ablation therapy, and summarize the current indications and outcomes of reported clinical use in comparison with that of other modalities.展开更多
目的:探讨磁共振功能成像方法扩散加权成像(DWI)和动态对比增强磁共振成像(DCE-MRI)在直肠癌T分期中的应用价值。方法:通过对78例经病理证实的直肠癌患者DWI及DCE-MRI图像进行回顾性分析,对比分析常规序列检查及磁共振功能成像联合常规...目的:探讨磁共振功能成像方法扩散加权成像(DWI)和动态对比增强磁共振成像(DCE-MRI)在直肠癌T分期中的应用价值。方法:通过对78例经病理证实的直肠癌患者DWI及DCE-MRI图像进行回顾性分析,对比分析常规序列检查及磁共振功能成像联合常规序列检查T分期诊断差异,ADC值及DCE-MRI定量参数Ktrans、Ve、Kep值与肿瘤的T分期的相关性。结果:磁共振功能成像联合常规序列检查T分期正确68例、准确率87.2%对直肠癌术前T分期与术后病理的一致性优于常规序列检查T分期正确59例,准确率75.6%(Kappa值0.81 vs 0.65,P<0.05);ADC值及DCE-MRI定量参数Ktrans、Ve值随肿瘤T分期的增加(均P<0.05);Kep值差异无统计学意义。结论:ADC值及DCE-MRI定量参数Ktrans、Ve值与直肠癌的T分期存在一定的相关性,磁共振功能成像能有效提高直肠癌术前T分期的准确率,对判断肿瘤在直肠壁的浸润深度具有一定的临床应用价值。展开更多
目的探讨动态增强磁共振(DCEMRI)的半定量与定量参数在前列腺癌诊断中的应用价值。方法搜集我院行前列腺DCE-MRI及穿刺病理活检的前列腺癌(PCa)及良性前列腺增生(BPH)各30例;DCE-MRI图像后处理绘制感兴趣区(ROI)并测量半定量参数,包括...目的探讨动态增强磁共振(DCEMRI)的半定量与定量参数在前列腺癌诊断中的应用价值。方法搜集我院行前列腺DCE-MRI及穿刺病理活检的前列腺癌(PCa)及良性前列腺增生(BPH)各30例;DCE-MRI图像后处理绘制感兴趣区(ROI)并测量半定量参数,包括时间信号曲线(TIC)类型、达峰时间(TTP)、强化峰值(SImax)、早期强化率等(SI1'/SImax),以及定量参数包括Ktrans、Kep、Ve,并进行统计学分析。结果 PCa组与BPH组TIC曲线类型有显著差异:PCa组中III型曲线超过一半;BPH组中I型曲线占2/3。半定量参数TTP、SImax、SI1'/SImax在PCa组分别为(115.3±32.1)s、(2.73±0.62)mmol/L、0.79±0.21;在BPH组分别为(271.6±29.2)s、(2.25±0.54)mmol/L、0.53±0.30。其中TTP、SI1'/SImax差异具有统计学意义。定量参数Kt r a n s、Kep、Ve在PCa组分别为(0.28±0.19)/min、(0.42±0.29)/min、0.61±0.28;在BPH组分别为(0.17±0.26)/min、(0.34±0.24)/min、0.55±0.31。其中Ktrans、Kep值差异具有统计学意义。在表现为II型TIC曲线的PCa病例与BPH病例之间比较各定量参数,其中Ktrans值差异仍有统计学意义。结论 DCE-MRI对前列腺癌与良性前列腺增生的鉴别诊断提供了重要信息,以I型曲线诊断BPH及III型曲线诊断PCa均有较高准确率,结合定量参数Ktrans、Kep值,对PCa诊断有进一步价值。展开更多
文摘目的观察动态增强磁共振(DCE-MRI)能否在术前判断直肠癌新辅助治疗的疗效,比较常规T2WI与DCE-MRI对直肠癌术前T、N分期的准确性。方法收集术前或术后病理确诊的直肠癌患者40例。其中行术前新辅助治疗者22例,未进行术前新辅助治疗者18例。所有患者均在GE1.5T Twinspeed HD MR扫描仪行盆腔动态增强扫描。扫描序列包括T2WI压脂、T1WI、DWI,快速三维容积T1加权脂肪抑制成像增强扫描(3DLAVA)。分析动态增强曲线的各项参数在新辅助治疗前后的变化,观察癌灶曲线上升速率。结果①对未进行术前治疗的直肠癌分期的准确性:DCE-MRI与常规T2WI对直肠癌T分期的准确性分别为83.3%和66.7%,对环周切缘阴性判断准确性为88.2%和70.6%。T2WI及DCE-MRI均能发现直径≥2mm的淋巴结。②对新辅助治疗后直肠癌再分期的准确性:DCE-MRI对T、N再分期的准确性可达86.4%和81.8%,对环周切缘情况判断准确性为100%。而T2WI进行T、N再分期较困难。③治疗前癌灶的曲线上升速率明显高于正常肠管;治疗后达病理完全缓解组原癌灶部略低于下段正常肠管,但是差异不明显;治疗后未达病理完全缓解组癌灶部仍高于下段正常肠管。结论DCE-MRI对术前直肠癌分期的准确性高,并能够准确判断新辅助治疗后癌周切缘情况。癌灶与参照肠管的上升速率比较有助于在术前判断疗效。
文摘Local ablative techniques-percutaneous ethanol injection, microwave coagulation therapy and radiofrequency ablation (RFA)-have been developed to treat unresectable hepatocellular carcinoma (HCC). The success rate of percutaneous ablation therapy for HCC depends on correct targeting of the tumor via an imaging technique. However, probe insertion often is not completely accurate for small HCC nodules, which are poorly def ined on conventional B-mode ultrasound (US) alone. Thus, multiple sessions of ablation therapy are frequently required in diffi cult cases. By means of two breakthroughs in US technology, harmonic imaging and the development of second-generation contrast agents, dynamic contrast-enhanced harmonic US imaging with an intravenous contrast agent can depict tumor vascularity sensitively and accurately, and is able to evaluate small hypervascular HCCs even when B-mode US cannot adequately characterize the tumors. Therefore, dynamic contrast-enhanced US can facilitate RFA electrode placement in hypervascular HCC, which is poorly depicted by B-mode US. The use of dynamic contrast-enhanced US guidance in ablation therapy for liver cancer is an effi cient approach. Here, we present an overview of the current status of dynamic contrast-enhanced US-guided ablation therapy, and summarize the current indications and outcomes of reported clinical use in comparison with that of other modalities.
文摘目的:探讨磁共振功能成像方法扩散加权成像(DWI)和动态对比增强磁共振成像(DCE-MRI)在直肠癌T分期中的应用价值。方法:通过对78例经病理证实的直肠癌患者DWI及DCE-MRI图像进行回顾性分析,对比分析常规序列检查及磁共振功能成像联合常规序列检查T分期诊断差异,ADC值及DCE-MRI定量参数Ktrans、Ve、Kep值与肿瘤的T分期的相关性。结果:磁共振功能成像联合常规序列检查T分期正确68例、准确率87.2%对直肠癌术前T分期与术后病理的一致性优于常规序列检查T分期正确59例,准确率75.6%(Kappa值0.81 vs 0.65,P<0.05);ADC值及DCE-MRI定量参数Ktrans、Ve值随肿瘤T分期的增加(均P<0.05);Kep值差异无统计学意义。结论:ADC值及DCE-MRI定量参数Ktrans、Ve值与直肠癌的T分期存在一定的相关性,磁共振功能成像能有效提高直肠癌术前T分期的准确率,对判断肿瘤在直肠壁的浸润深度具有一定的临床应用价值。
文摘目的探讨动态增强磁共振(DCEMRI)的半定量与定量参数在前列腺癌诊断中的应用价值。方法搜集我院行前列腺DCE-MRI及穿刺病理活检的前列腺癌(PCa)及良性前列腺增生(BPH)各30例;DCE-MRI图像后处理绘制感兴趣区(ROI)并测量半定量参数,包括时间信号曲线(TIC)类型、达峰时间(TTP)、强化峰值(SImax)、早期强化率等(SI1'/SImax),以及定量参数包括Ktrans、Kep、Ve,并进行统计学分析。结果 PCa组与BPH组TIC曲线类型有显著差异:PCa组中III型曲线超过一半;BPH组中I型曲线占2/3。半定量参数TTP、SImax、SI1'/SImax在PCa组分别为(115.3±32.1)s、(2.73±0.62)mmol/L、0.79±0.21;在BPH组分别为(271.6±29.2)s、(2.25±0.54)mmol/L、0.53±0.30。其中TTP、SI1'/SImax差异具有统计学意义。定量参数Kt r a n s、Kep、Ve在PCa组分别为(0.28±0.19)/min、(0.42±0.29)/min、0.61±0.28;在BPH组分别为(0.17±0.26)/min、(0.34±0.24)/min、0.55±0.31。其中Ktrans、Kep值差异具有统计学意义。在表现为II型TIC曲线的PCa病例与BPH病例之间比较各定量参数,其中Ktrans值差异仍有统计学意义。结论 DCE-MRI对前列腺癌与良性前列腺增生的鉴别诊断提供了重要信息,以I型曲线诊断BPH及III型曲线诊断PCa均有较高准确率,结合定量参数Ktrans、Kep值,对PCa诊断有进一步价值。
