磁共振弥散加权成像观察胰腺癌冷冻术后近期疗效的应用价值

发布时间：2018-03-03 02:04

本文选题：磁共振弥散加权成像　切入点：表观弥散系数　出处：《介入放射学杂志》2017年02期 　论文类型：期刊论文

【摘要】：目的探讨采用磁共振弥散加权成像(MRI-DWI)评估胰腺癌冷冻术后肿瘤坏死及肿瘤残存的应用价值。方法对接受冷冻治疗的26例胰腺癌患者行T_1WI、T_2WI常规MRI平扫、DWI序列及动态增强扫描。观察胰腺癌冷冻前后MRI信号改变。测量并比较正常胰腺、术前肿瘤组织及术后残存、坏死组织的表现弥散系数(ADC)值。评价肿瘤组织ADC值与肿瘤大小的相关性,不同肿瘤直径、肿瘤位置及分期表现ADC值的差异。结果 26例患者中16例肿瘤完全坏死,冷冻坏死的胰腺肿瘤组织在T_1WI图像上呈低信号,T_2WI呈高信号,DWI呈低信号,动态增强无强化。活性肿瘤组织残留9例(其中7例肿瘤直径5.0 cm),残留率为34.6%。ADC值由低到高依次为:术前胰腺肿瘤组织(1.022±0.126)×10~(-3)mm~2/s、术后残存肿瘤组织(1.130±0.155)×10~(-3)mm~2/s、正常胰腺组织(1.924±0.124)×10~(-3) mm~2/s及术后坏死组织(2.312±0.214)×10~(-3)mm~2/s。术前胰腺肿瘤组织ADC值与术后残存肿瘤组织相比,差异无统计学意义(P=0.452),与正常胰腺组织、术后坏死组织相比,差异有显著统计学意义(P0.001)。胰腺肿瘤ADC值与肿瘤大小呈负相关(R=-0.43,P=0.027 2),与肿瘤位置、肿瘤分期无关(P=0.738 8,P=0.089 5)。结论 DWI能有效鉴别胰腺癌冷冻治疗后的病灶坏死及残存,为进一步临床诊治提供依据。
[Abstract]:Objective to evaluate the value of Mr diffusion-weighted Mr imaging (MRI-DWI) in evaluating tumor necrosis and tumor remnant after cryopreservation of pancreatic cancer. Methods 26 patients with pancreatic cancer received cryotherapy were treated with T1WIW / T2WI MRI plain DWI sequence and dynamic changes. Contrast-enhanced scanning. The changes of MRI signal before and after cryopreservation were observed. The normal pancreas was measured and compared. The diffusion coefficient of necrotic tissue was evaluated to evaluate the correlation between tumor ADC and tumor size, and the diameter of tumor. Results among 26 patients, 16 cases were completely necrotic, 16 cases of frozen necrotic pancreatic tumor tissue showed low signal intensity on T 1WI images, and high signal intensity on T 2WI showed low signal intensity on T 2WI. Dynamic contrast enhancement was not enhanced in 9 cases (of which 7 cases had tumor diameter 5.0 cm ~ (-1)), and the residual rate was 34.6.ADC value from low to high was 1.022 卤0.126) 脳 10 ~ (-3) mm ~ (-1) / s in pancreatic tumor tissue before operation, 1.130 卤0.155 脳 10 ~ (-3) mm ~ (-2 / s) in residual tumor tissue after operation, 1.924 卤0.124 脳 10 ~ (-3) mm ~ (-2) / s in normal pancreatic tissue and 1. 924 卤0.124 脳 10 ~ (-3) mm / s in normal pancreas tissue. Postoperative necrotic tissue was 2.312 卤0.214) 脳 10 ~ (-3) mm ~ (-2 / s) s. The preoperative ADC value of pancreatic tumor tissue was higher than that of postoperative residual tumor tissue. There was no significant difference in ADC between normal pancreas and necrotic tissue after operation (P 0.001). The ADC value of pancreatic tumor was negatively correlated with tumor size, and correlated with the location of the tumor. Conclusion DWI can effectively differentiate necrosis and residual lesions after cryotherapy of pancreatic cancer and provide evidence for further clinical diagnosis and treatment.
【作者单位】：乌兰浩特市人民医院;暨南大学医学院附属复大肿瘤医院;吉林大学第二医院;
【基金】：广州市天河区科技计划项目(201504KW013)
【分类号】：R735.9;R445.2

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