發(fā)布時(shí)間：2018-02-27 13:29

  本文關(guān)鍵詞： 膠質(zhì)瘤 治療 擴(kuò)散磁共振成像 表觀擴(kuò)散系數(shù) 腫瘤進(jìn)展　出處：《中國(guó)醫(yī)學(xué)影像技術(shù)》2017年08期 　論文類型：期刊論文

【摘要】：目的探討應(yīng)用多b值DWI中不同b值A(chǔ)DC值評(píng)估膠質(zhì)瘤近期治療效果及鑒別腫瘤進(jìn)展的價(jià)值。方法對(duì)47例經(jīng)手術(shù)病理證實(shí)為腦膠質(zhì)瘤且接受聯(lián)合放化療的患者行常規(guī)MRI及多b值DWI(b=0、1 000、2 000、3 000s/mm~2)掃描。分別在5種不同b值組合(b值組合分別為:0、1 000s/mm~2,0、2 000s/mm~2,0、3 000s/mm~2,1 000、3 000s/mm~2,2 000、3 000s/mm~2)的ADC圖[ADC_((1 000/0))、ADC_((/2 000/0))、ADC_((3 000/0))、ADC_((3 000/1 000))、ADC_((3 000/2 000))]中測(cè)量病灶的平均和最小ADC值(ADC_(mean)和ADCmin),計(jì)算其相對(duì)值(rADC_(mean)、rADCmin)。比較治療后不同反應(yīng)類型(完全有效、部分有效、穩(wěn)定、進(jìn)展)間及進(jìn)展組與非進(jìn)展組間ADC值的差異,通過(guò)ROC曲線分析不同ADC值診斷腫瘤進(jìn)展的最佳臨界值和診斷效能。結(jié)果 ADC_((3 000/0))、ADC_((3 000/1 000))和ADC_((3 000/2 000))圖中的rADC_(mean)在不同反應(yīng)類型間和進(jìn)展組與非進(jìn)展組間差異均有統(tǒng)計(jì)學(xué)意義(P均0.05);ADC_((3 000/1 000))和ADC_((3 000/2 000))圖中的ADC_(mean)在不同反應(yīng)類型間和進(jìn)展組與非進(jìn)展組間差異均有統(tǒng)計(jì)學(xué)意義(P均0.05)。ADC_((3 000/2 000))圖中ADC_(mean)和rADC_(mean)診斷腫瘤進(jìn)展的曲線下面積最大,分別為0.86和0.84,以ADC_(mean)=408.65×10~(-6)mm~2/s和rADC_(mean)=1.12診斷膠質(zhì)瘤進(jìn)展的敏感度、特異度分別為89.3%、71.0%和92.9%、77.4%。結(jié)論通過(guò)高b值A(chǔ)DC圖中病灶的ADC_(mean)和rADC_(mean)可較準(zhǔn)確地評(píng)估膠質(zhì)瘤的近期治療效果,并為鑒別膠質(zhì)瘤術(shù)后腫瘤進(jìn)展提供有價(jià)值的信息。
[Abstract]:Objective to evaluate the value of different b value ADC values of multiple b DWI in evaluating the short-term therapeutic effect of gliomas and differentiating the progression of gliomas. Methods 47 patients with gliomas confirmed by surgery and pathology who received combined radiotherapy and chemotherapy were treated with routine procedure. MRI and multi-b DWIBU / 2000 / 2000 / 3 000s / mm-2) scanning. The average and minimum ADC values of ADC were measured in 5 different combinations of b values of 0 1 000 s / r / mm / 2 0 000 s / r / m / 2 000 s / r / r / t / 2 000 s / r / m / 2000s / r / r 2000sr / mm / 2000sr / r / r 2000s / r / m ~ 2000s / r / r ADC_((1 / 2000 / P / P / P / P / P / P / P / P / P of ADCA / ADCD / P / P / P / P / P / 0 / 0 / 0 respectively.] average and minimum ADC values were calculated for the mean and minimum ADC values of DCQ / ADCP / ADCP / ADCP / ADCP / 0 / 0 / 0 / 0 / 0 / 0 / 0 / 0 / 0 / 0 / 5 respectively.] the mean and minimum ADC values of the lesions were measured and the mean and minimum ADC values were calculated. The mean value of rADCM was compared with that of different types of response after treatment. The difference of ADC values between the partially effective, stable and progressive groups and between the progressive group and the non-progressive group, ROC curves were used to analyze the best critical value and diagnostic efficacy of different ADC values for diagnosis of tumor progression. Results there were significant differences in the rADCC mean between different reaction types and between progressive and non-progressive groups in the ADC_((3 000 / 0 0 / 0 ADC_((3 / D 0 / 0 0 / 0 / 10 ~ (000) and ADC_((3 000/2 ~ 000N) charts. There were significant differences between the two groups in terms of ADCS and ADC_((3 000/2 000). There were significant differences between the different reaction types and between the progressive group and the non progressive group. There was the largest area under the curve of ADCS mean and rADCmean) in the map of ADCS mean) and rADCmean for the diagnosis of the progression of the tumor, and the difference between the two groups was statistically significant (P = 0.05 and 0.05 respectively) and the area under the curve of the RAD mean was the largest in the map of ADCS and ADC_((3 000/2 000 (P = 0.05) and the difference between the progressive group and the non-progressive group was significant. The sensitivity of ADC_(mean)=408.65 脳 10 ~ (-6) / 2 / s and rADC_(mean)=1.12 in the diagnosis of glioma progression was 89.3% and 92.9%, respectively. Conclusion the short-term therapeutic effect of glioma can be evaluated more accurately by means of the ADCS mean and rADCV mean of the lesions on the high b value ADC map, and the sensitivity of the two methods is 89. 3% and 92. 9% respectively. It also provides valuable information for differentiating tumor progression after glioma operation.
【作者單位】： 河北醫(yī)科大學(xué)第二醫(yī)院影像科;黃驊市人民醫(yī)院影像科;
【分類號(hào)】：R445.2;R739.41

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