DWI在听神经瘤伽玛刀治疗后早期疗效评估中的价值

发布时间：2018-05-25 08:39

本文选题：扩散加权成像 + 听神经瘤　；参考：《中国医学计算机成像杂志》2017年04期

【摘要】：目的:观察听神经瘤伽玛刀治疗前后ADC值的变化特点,探讨磁共振扩散加权成像(DWI)在评估听神经瘤伽玛刀治疗后早期疗效中的价值。方法:62例听神经瘤患者,其中,男性38例,女性24例,年龄23~78岁,平均年龄45.3±5.9岁。采用医科达公司Leksell伽玛刀,处方剂量为12~13Gy(中心剂量24~27Gy)。所有患者在治疗前及治疗后8个月均行常规MRI及DWI检查,并采用Functool 9.4.05a软件计算肿瘤体积、表观扩散系数(ADC)值及指数化表观扩散系数(e ADC)值。结果:62个采用伽玛刀治疗的听神经瘤病灶,30例(48.4%)肿瘤稳定,21例(33.9%)体积增大,11例(17.7%)体积缩小。其治疗前体积、ADC及e ADC值分别为5.052±2.995cm3、(1.374±0.681)×10~(-3)mm~2/s和0.289±0.063;而伽玛刀治疗后8个月分别为5.281±3.375cm3、(1.658±0.340)×10~(-3)mm~2/s和0.224±0.088。采用配对样本t检验进行统计学分析发现,结果显示治疗前后体积的变化无统计学差异(t=-1.100,P=0.275),ADC值(t=-3.021,P=0.004)及e ADC值(t=5.502,P=0.000)的变化均有显著统计学差异。结论:磁共振扩散加权成像(DWI)在听神经瘤伽玛刀治疗后早期疗效评估中有一定价值,ADC及e ADC值可以早期提示肿瘤对治疗的反应。
[Abstract]:Objective: to observe the changes of ADC in acoustic neuroma before and after gamma knife therapy, and to evaluate the value of diffusion weighted imaging (DWI) in evaluating the early therapeutic effect of acoustic neuroma after gamma knife therapy. Methods Sixty-two patients with acoustic neuroma, including 38 males and 24 females, aged 2378 years, with an average age of 45.3 卤5.9 years. Leksell gamma knife was used in the medical company. The prescription dose was 12g / 13Gy (central dose: 244g / 27Gy / kg). All patients were examined by routine MRI and DWI before treatment and 8 months after treatment. Tumor volume, apparent diffusion coefficient and exponential apparent diffusion coefficient were calculated by Functool 9.4.05a software. Results: in 62 cases of acoustic neuroma treated with gamma knife, 30 cases (48.4 cases) were treated with gamma knife) the tumor was stable in 21 cases (33.9%) and the volume was increased in 11 cases (17.7%). The values of ADCs and e ADC before treatment were 5.052 卤2.995cm ~ (3) C ~ (-1) 卤0.681) 脳 10~(-3)mm~2/s and 0.289 卤0.063, respectively, compared with 5.281 卤3.375 cm ~ (3) C ~ (3 +) 10~(-3)mm~2/s 脳 10~(-3)mm~2/s and 0.224 卤0.088 at 8 months after gamma knife therapy, respectively. The results showed that there was no significant difference in the changes of volume before and after treatment. There were significant differences between the two groups in the changes of the ADC values (t = -3.021) and e ADC values (P < 5.502P ~ (0. 000) before and after the treatment. The results showed that there was no significant difference in the changes of the volume between the two groups before and after treatment, and there was no significant difference between the two groups in the changes of the volume of the samples before and after treatment. Conclusion: Mr diffusion weighted imaging (DWI) has a certain value in evaluating the early therapeutic effect of acoustic neuroma after gamma knife therapy. The values of ADC and e ADC can early indicate the response of tumor to the treatment.
【作者单位】：复旦大学附属华山医院上海伽玛医院放射科;
【分类号】：R445.2;R739.4

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