DWI及ADC值在胃癌淋巴结性质判断及化疗疗效评估中的作用

发布时间：2018-06-21 08:04

本文选题：胃肿瘤 + 淋巴结　；参考：《放射学实践》2015年05期

【摘要】：目的:探讨扩散加权成像(DWI)及表观扩散系数(ADC)值在进展期胃癌淋巴结性质判断中的价值,进一步探讨其在化疗疗效动态监测中的应用价值。方法:44例伴有可测淋巴结的进展期胃癌患者,分别于化疗前、化疗后3、7、30和60d行MRI-DWI检查,测量化疗前和化疗后60d每个淋巴结的长径、垂直短径,以及化疗前和化疗后各时间点每个淋巴结的ADC值,化疗后60d行手术切除及淋巴结清扫,分组切除淋巴结共1258枚送病理活检,标记淋巴结组别,按照病理结果分为全阳性组(231枚,整组切除之淋巴结均有转移)和全阴性组(495枚,整组切除之淋巴结均无转移),分析比较两组间化疗前淋巴结长径、短径及ADC值差异,分析全阳性组中各疗效组化疗前后不同时间点ADC值差异并进行统计学处理。结果:化疗前全阳性组与全阴性组淋巴结长径、短径及ADC值差异均有统计学意义(P0.05)。全阳性组中部分有效组(PR组)及稳定组(SD组)化疗前、化疗后3、7、30和60dADC值均呈上升趋势,化疗前与化疗后各时间点的ADC值差异均有统计学意义(P0.05);完全有效组(CR组)可测时间点内随时间进展ADC值也呈上升趋势,化疗前与化疗后各可测时间点的ADC值差异均有统计学意义(P0.05)。结论:DWI及ADC值可初步判断胃癌患者可测淋巴结的性质,并可动态观察和早期定量监测胃癌患者转移性淋巴结的化疗疗效。
[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.
【作者单位】：第四军医大学西京医院放射科;第四军医大学西京医院核医学科;香港大学深圳医院;第四军医大学西京医院消化病医院;
【基金】：国家自然科学基金资助项目(81220108011,81370039)
【分类号】：R735.2;R445.2

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