多b值DWI在脑胶质瘤治疗后近期评价中的应用

发布时间：2018-02-27 13:29

本文关键词： 胶质瘤治疗扩散磁共振成像表观扩散系数肿瘤进展　出处：《中国医学影像技术》2017年08期 　论文类型：期刊论文

【摘要】：目的探讨应用多b值DWI中不同b值ADC值评估胶质瘤近期治疗效果及鉴别肿瘤进展的价值。方法对47例经手术病理证实为脑胶质瘤且接受联合放化疗的患者行常规MRI及多b值DWI(b=0、1 000、2 000、3 000s/mm~2)扫描。分别在5种不同b值组合(b值组合分别为: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图[ADC_((1 000/0))、ADC_((/2 000/0))、ADC_((3 000/0))、ADC_((3 000/1 000))、ADC_((3 000/2 000))]中测量病灶的平均和最小ADC值(ADC_(mean)和ADCmin),计算其相对值(rADC_(mean)、rADCmin)。比较治疗后不同反应类型(完全有效、部分有效、稳定、进展)间及进展组与非进展组间ADC值的差异,通过ROC曲线分析不同ADC值诊断肿瘤进展的最佳临界值和诊断效能。结果 ADC_((3 000/0))、ADC_((3 000/1 000))和ADC_((3 000/2 000))图中的rADC_(mean)在不同反应类型间和进展组与非进展组间差异均有统计学意义(P均0.05);ADC_((3 000/1 000))和ADC_((3 000/2 000))图中的ADC_(mean)在不同反应类型间和进展组与非进展组间差异均有统计学意义(P均0.05)。ADC_((3 000/2 000))图中ADC_(mean)和rADC_(mean)诊断肿瘤进展的曲线下面积最大,分别为0.86和0.84,以ADC_(mean)=408.65×10~(-6)mm~2/s和rADC_(mean)=1.12诊断胶质瘤进展的敏感度、特异度分别为89.3%、71.0%和92.9%、77.4%。结论通过高b值ADC图中病灶的ADC_(mean)和rADC_(mean)可较准确地评估胶质瘤的近期治疗效果,并为鉴别胶质瘤术后肿瘤进展提供有价值的信息。
[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.
【作者单位】：河北医科大学第二医院影像科;黄骅市人民医院影像科;
【分类号】：R445.2;R739.41

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