發(fā)布時間：2018-06-21 08:04

  本文選題：胃腫瘤 + 淋巴結��； 參考：《放射學實踐》2015年05期

【摘要】：目的:探討擴散加權成像(DWI)及表觀擴散系數(shù)(ADC)值在進展期胃癌淋巴結性質判斷中的價值,進一步探討其在化療療效動態(tài)監(jiān)測中的應用價值。方法:44例伴有可測淋巴結的進展期胃癌患者,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的ADC值,化療后60d行手術切除及淋巴結清掃,分組切除淋巴結共1258枚送病理活檢,標記淋巴結組別,按照病理結果分為全陽性組(231枚,整組切除之淋巴結均有轉移)和全陰性組(495枚,整組切除之淋巴結均無轉移),分析比較兩組間化療前淋巴結長徑、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值差異并進行統(tǒng)計學處理。結果:化療前全陽性組與全陰性組淋巴結長徑、短徑及ADC值差異均有統(tǒng)計學意義(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)計學意義(P0.05);完全有效組(CR組)可測時間點內隨時間進展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)計學意義(P0.05)。結論:DWI及ADC值可初步判斷胃癌患者可測淋巴結的性質,并可動態(tài)觀察和早期定量監(jiān)測胃癌患者轉移性淋巴結的化療療效。
[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)大學西京醫(yī)院放射科;第四軍醫(yī)大學西京醫(yī)院核醫(yī)學科;香港大學深圳醫(yī)院;第四軍醫(yī)大學西京醫(yī)院消化病醫(yī)院;
【基金】：國家自然科學基金資助項目(81220108011,81370039)
【分類號】：R735.2;R445.2

【參考文獻】

相關期刊論文 前2條

1 李婷;朱凱;郭玉林;何花;張小彪;田兆榮;;3.0T MR擴散加權成像在不同分化程度胃癌中的診斷價值[J];磁共振成像;2014年03期

2 楊鳳嬌;鄭玄中;楊曉棠;;進展期胃癌新輔助化療療效評價的影像學方法研究進展[J];實用醫(yī)學影像雜志;2012年02期

【共引文獻】

相關期刊論文 前10條

1 張雷;邵國良;;胃癌的功能磁共振成像進展[J];國際醫(yī)學放射學雜志;2013年03期

2 何萍;王燕;楊晟;于舒飛;王子平;李峻嶺;王彬;郝學志;王宏羽;胡興勝;張湘茹;石遠凱;;191例EGFR突變狀態(tài)不明晚期肺腺癌患者EGFR-TKIs耐藥后化療的療效分析[J];中國肺癌雜志;2013年10期

3 李海明;;動態(tài)增強MRI在卵巢腫瘤中的研究進展[J];放射學實踐;2013年09期

4 蔡江河;項昌盛;李靜;張守福;陳茂華;;自擬肺癌方治療晚期非小細胞肺癌療效觀察[J];中醫(yī)藥臨床雜志;2013年10期

5 張弘;趙涓涓;皮亞平;徐敏;李志紅;張軍;;乳腺癌病灶Her2、EGF表達與乳腺癌化療療效和預后的關系[J];重慶醫(yī)學;2013年29期

6 鄭蕾;林寶釵;宋正波;謝發(fā)君;洪衛(wèi);馮建國;邵嵐;張沂平;;BIM基因多態(tài)性與復治晚期非小細胞肺癌EGFR-TKI治療療效的關系[J];中國肺癌雜志;2013年12期

7 劉旭;王燕;李淑芳;辛士珍;曹建存;;化療對肺癌患者生活質量的影響[J];中國肺癌雜志;2013年12期

8 Xiao-Yu Yang;Feng Xie;Ran Tao;Ai-Jun Li;Meng-Chao Wu;;Treatment of liver metastases from uveal melanoma: a retrospective single-center analysis[J];Hepatobiliary & Pancreatic Diseases International;2013年06期

9 黃莎;范南峰;李惠;楊建偉;;一線聯(lián)合化療后替吉奧維持治療晚期胃癌24例臨床分析[J];福建醫(yī)藥雜志;2013年05期

10 曾冬香;畢延智;盛桂鳳;董益忠;宋紅蕾;;參一膠囊在晚期非小細胞肺癌維持治療中的療效觀察[J];癌癥進展;2013年06期

相關會議論文 前10條

1 Ming Zhao;Jian-peng Wang;Chang-chuan Pan;Wang Li;Zi-lin Huang;Liang Zhang;Wei-jun Fang;Yong Jiang;xi-shan Li;Pei-hong Wu;;CT-guided radiofrequency ablation after with transarterial chemoembolization in treating unresectable hepatocellular carcinoma with long overall survival improvement[A];第九屆中國腫瘤微創(chuàng)治療學術大會論文集[C];2013年

2 趙曉陽;曹廣劭;曹會存;劉健;王玉丹;劉詩義;李天曉;王振豫;;PTCD聯(lián)合碘125粒子植入治療晚期胰腺癌合并梗阻性黃疸[A];第九屆中國腫瘤微創(chuàng)治療學術大會論文集[C];2013年

3 Lizhi Niu;Lihua He;Liang Zhou;Feng Mu;Binghui Wu;Haibo Li;Zhenzhong Yang;Jiansheng Zuo;Kecheng Xu;;Percutaneous Ultrasonography and Computed Tomography Guided Pancreatic Cryoablation:Feasibility and Safety Assessment Technical Developments[A];第九屆中國腫瘤微創(chuàng)治療學術大會論文集[C];2013年

4 丁小兵;李觀華;戈華平;;新輔助化療方案FOLFOX6對進展期胃癌的療效觀察[A];江西省第二屆胃腸外科學術會議暨江西省第十二次中西醫(yī)結合普通外科學術會議論文匯編[C];2012年

5 向德雨;秦章祿;;進展期胃癌新輔助化療的研究進展[A];江西省第二屆胃腸外科學術會議暨江西省第十二次中西醫(yī)結合普通外科學術會議論文匯編[C];2012年

6 邵嵐;洪衛(wèi);張沂平;;聯(lián)合血清腫瘤標志物建立預測厄洛替尼治療復治非小細胞肺癌生存模型[A];2013華東胸部腫瘤論壇暨第六屆浙江省胸部腫瘤論壇論文集[C];2013年

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