本文選題：胃腫瘤 + 淋巴結(jié)�。� 參考：《放射學(xué)實踐》2015年05期

【摘要】：目的:探討擴(kuò)散加權(quán)成像(DWI)及表觀擴(kuò)散系數(shù)(ADC)值在進(jìn)展期胃癌淋巴結(jié)性質(zhì)判斷中的價值,進(jìn)一步探討其在化療療效動態(tài)監(jiān)測中的應(yīng)用價值。方法:44例伴有可測淋巴結(jié)的進(jìn)展期胃癌患者,分別于化療前、化療后3、7、30和60d行MRI-DWI檢查,測量化療前和化療后60d每個淋巴結(jié)的長徑、垂直短徑,以及化療前和化療后各時間點每個淋巴結(jié)的ADC值,化療后60d行手術(shù)切除及淋巴結(jié)清掃,分組切除淋巴結(jié)共1258枚送病理活檢,標(biāo)記淋巴結(jié)組別,按照病理結(jié)果分為全陽性組(231枚,整組切除之淋巴結(jié)均有轉(zhuǎn)移)和全陰性組(495枚,整組切除之淋巴結(jié)均無轉(zhuǎn)移),分析比較兩組間化療前淋巴結(jié)長徑、短徑及ADC值差異,分析全陽性組中各療效組化療前后不同時間點ADC值差異并進(jìn)行統(tǒng)計學(xué)處理。結(jié)果:化療前全陽性組與全陰性組淋巴結(jié)長徑、短徑及ADC值差異均有統(tǒng)計學(xué)意義(P0.05)。全陽性組中部分有效組(PR組)及穩(wěn)定組(SD組)化療前、化療后3、7、30和60dADC值均呈上升趨勢,化療前與化療后各時間點的ADC值差異均有統(tǒng)計學(xué)意義(P0.05);完全有效組(CR組)可測時間點內(nèi)隨時間進(jìn)展ADC值也呈上升趨勢,化療前與化療后各可測時間點的ADC值差異均有統(tǒng)計學(xué)意義(P0.05)。結(jié)論:DWI及ADC值可初步判斷胃癌患者可測淋巴結(jié)的性質(zhì),并可動態(tài)觀察和早期定量監(jiān)測胃癌患者轉(zhuǎn)移性淋巴結(jié)的化療療效。
[Abstract]:Objective: to investigate the value of diffusion weighted imaging (DWI) and apparent diffusion coefficient (ADCC) in the diagnosis of lymph node characteristics of advanced gastric cancer and to explore the value of DWI and ADCI in dynamic monitoring of chemotherapy efficacy. Methods 44 cases of advanced gastric cancer with measurable lymph nodes were examined by MRI-DWI before chemotherapy, 3 days after chemotherapy and 60 days after chemotherapy. The length and vertical short diameter of each lymph node were measured before chemotherapy and 60 days after chemotherapy. The ADC value of each lymph node before and after chemotherapy was calculated. 1258 lymph nodes were removed and dissected 60 days after chemotherapy. A total of 1258 lymph nodes were removed and labeled with pathological biopsy. According to the pathological results, 1258 lymph nodes were divided into total positive group and total positive group. There were 495 lymph nodes with metastasis in the whole group and none in the negative group. The difference of the length, short diameter and ADC value of lymph nodes before chemotherapy between the two groups was analyzed and compared. The ADC values at different time points before and after chemotherapy in all positive group were analyzed and statistically analyzed. Results: there were significant differences in lymph node length, short diameter and ADC between total positive group and total negative group before chemotherapy (P 0.05). The ADC values of partial effective group (PR group) and stable group (SD group) before and after chemotherapy showed an increasing trend at 730 and 60 days after chemotherapy. The ADC values of all time points before chemotherapy and after chemotherapy were significantly different (P < 0.05). The ADC values of each measurable time point before chemotherapy and after chemotherapy were significantly different (P 0.05). Conclusion the value of DWI and ADC can be used to determine the measurable lymph nodes in patients with gastric cancer, and the chemotherapeutic effects of metastatic lymph nodes in patients with gastric cancer can be observed dynamically and quantitatively in the early stage.
【作者單位】： 第四軍醫(yī)大學(xué)西京醫(yī)院放射科;第四軍醫(yī)大學(xué)西京醫(yī)院核醫(yī)學(xué)科;香港大學(xué)深圳醫(yī)院;第四軍醫(yī)大學(xué)西京醫(yī)院消化病醫(yī)院;
【基金】：國家自然科學(xué)基金資助項目(81220108011,81370039)
【分類號】：R735.2;R445.2

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