本文關(guān)鍵詞：3.0T磁共振擴散加權(quán)成像對食管鱗癌放化療早期療效的評估價值　出處：《川北醫(yī)學(xué)院》2015年碩士論文　論文類型：學(xué)位論文

  更多相關(guān)文章： 擴散加權(quán)成像 表觀彌散系數(shù) 食管癌 放化療

【摘要】：目的:探討3.0T磁共振擴散加權(quán)成像(DWI)表觀擴散系數(shù)數(shù)值(ADC值)評價中晚期食管鱗癌放化療早期療效的價值。材料與方法:收集31例經(jīng)病理證實的食管鱗癌患者,在治療前、放療11次及放療32次行常規(guī)MRI及DWI掃描,b值選取800s/mm2掃描。以腫瘤最大層面為準(zhǔn),測量腫瘤最大徑(Φ)。以治療結(jié)束(放療32次)作為療效評價時間點,應(yīng)用WHO2009年最新發(fā)布的實體腫瘤療效評價標(biāo)準(zhǔn)RECIST修訂版(version 1.1)進行療效評價,將患者分為反應(yīng)組(CR和PR)與無反應(yīng)組(SD和PD)。對比分析治療前反應(yīng)組與無反應(yīng)組ADC值(ADC0)、放療11次及放療32次時反應(yīng)組與無反應(yīng)組ADC值(ADC11、ADC32)及治療前后ADC值變化率(△ADC)。結(jié)果:根據(jù)評價標(biāo)準(zhǔn)將患者分為兩組,其中反應(yīng)組21例(68%),無反應(yīng)組10例(32%),在軸位T2WI圖像上腫瘤最大直徑為反應(yīng)組(30.03±3.21)mm,無反應(yīng)組(32.03±4.21)mm,(p0.05)。本研究治療前反應(yīng)組和無反應(yīng)組ADC值分別為(1.431±0.046)×10-3mm2/s、(1.461±0.015)×10-3mm2/s,(p0.05)。當(dāng)放療11次時,反應(yīng)組與無反應(yīng)組ADC值分別為(1.874±0.313)×10-3mm2/s、(1.589±0.324)×10-3mm2/s,(p0.05)。當(dāng)放療11次時,反應(yīng)組與無反應(yīng)組表觀擴散系數(shù)增長率△ADC11值分別為(31.54±15.573)%、(1.919±1.443)%,p0.05,反應(yīng)組比無反應(yīng)組表觀系數(shù)增長率△ADC11值明顯升高,具有統(tǒng)計學(xué)意義。當(dāng)放療32次時,反應(yīng)組與無反應(yīng)組表觀系數(shù)為(2.009±0.380)×10-3mm2/s,(1.770±0.440)×10-3mm2/s,p0.05)。當(dāng)放療32次時,反應(yīng)組與無反應(yīng)組表觀系數(shù)增長率△ADC32值分別為(34.91±15.305)%、(18.86±9.774)%,(p0.05)。當(dāng)放療11次時,△ADC11治療反應(yīng)ROC曲線下面積最大,數(shù)值為0.838,當(dāng)ADC為11.5%時,判定治療是否有效的敏感度及特異度分別為83.3%、76.9%。非線性Logistic回歸分析影響食管癌放化療敏感性的相關(guān)臨床因素(性別、年齡、△ADC11及△ADC32),結(jié)果顯示△ADC11是影響食管癌放化療敏感程度的獨立預(yù)后因素,其相對風(fēng)險度為1.108,p0.05。結(jié)論:DWI對于評價食管鱗癌放化療早期療效有重要作用。△ADC11可作為預(yù)測食管鱗癌早期放化療敏感性的最佳指標(biāo)和獨立預(yù)后因素。治療前ADC值(ADC0)尚不足以作為食管鱗癌放化療敏感性及早期療效的預(yù)測指標(biāo)。
[Abstract]:Objective: To investigate the 3.0T diffusion weighted magnetic resonance imaging (DWI) and apparent diffusion coefficient value (ADC value) in the evaluation of the curative effect of chemotherapy on advanced esophageal squamous cell carcinoma early value. Materials and methods: 31 patients with pathologically confirmed esophageal squamous cell carcinoma patients, before treatment, radiotherapy and radiotherapy 11 times 32 times for conventional MRI and DWI scanning, B = 800s/mm2 scan. The maximum level of tumor to prevail, measuring tumor size (PHI). At the end of treatment (32 treatments) as the evaluation time point responseevaluation criteria in solid tumors RECIST WHO2009 released the latest revised edition (version 1.1) to evaluate the curative effect, the patients were divided into the reaction group (CR and PR) and non response group (SD and PD). Comparative analysis before treatment response group and non response group ADC (ADC0), 11 times 32 times radiotherapy and radiotherapy response group and non response group ADC (ADC11, ADC32) and ADC values before and after treatment the rate of change (delta ADC results: according to the). 璇勪環(huán)鏍囧噯灝嗘?zhèn)ｈ�呭垎涓轟袱緇，

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