扩散加权成像对非手术喉癌和下咽癌患者同步放化疗前后的疗效评价

发布时间：2018-07-04 10:41

本文选题：喉肿瘤 + 下咽肿瘤　；参考：《磁共振成像》2016年03期

【摘要】：目的探讨磁共振扩散加权成像联合常规MRI检查评价非手术喉癌下咽癌同步放化疗疗效的应用价值。材料与方法搜集喉癌下咽癌患者(仅接受放化疗,未行手术治疗)共25例,全部病例均于患病局部活检或手术病理证实。所有患者治疗前均行常规MRI及扩散加权成像(DWI)扫描,分析患者MRI特点、测量肿瘤最大横截面积及表观扩散系数(ADC)值(包括平均ADC值、最低和最高ADC值);治疗后(放化疗结束后1个月内)再次行MRI检查,测残留肿瘤面积及ADC值,并计算肿瘤缓解率。分析治疗前及治疗后肿瘤ADC值与肿瘤缓解率相关性;分析治疗后完全缓解患者(CR组)与非完全缓解患者(非CR组)治疗前、后ADC值及变化的差异。结果 25例喉癌下咽癌患者治疗前肿瘤面积4.81(0.83~14.12)cm~2,治疗后肿瘤面积2.42(0~7.92)cm~2,肿瘤缓解率为74.8%(6.0%~100%),其中有11(11/25,44.0%)例患者治疗后肿瘤消失。治疗前肿瘤平均ADC值及最高ADC值与治疗后肿瘤缓解率呈负相关(r= 0.922、 0.691,P0.05),治疗后平均ADC值与缓解率呈正相关(r=0.678,P0.05);非CR组治疗前肿瘤平均、最高ADC值高于CR组,CR组治疗后平均ADC值及治疗前后平均ADC值的变化高于非CR组,差异有统计学意义(P值均0.05)。结论治疗前肿瘤ADC值以及治疗前后肿瘤ADC值的变化对评价非手术喉癌下咽癌放化疗后早期缓解率有一定意义。
[Abstract]:Objective to evaluate the clinical value of diffusion weighted Mr imaging (DWI) combined with conventional MRI in the evaluation of concurrent radiotherapy and chemotherapy for nonoperative hypopharyngeal carcinoma. Materials and methods A total of 25 patients with hypopharyngeal carcinoma (only received radiotherapy and chemotherapy without surgical treatment) were collected. All cases were confirmed by local biopsy or surgical pathology. All patients underwent conventional MRI and diffusion weighted imaging (DWI) before treatment. The characteristics of MRI were analyzed and the maximum cross-sectional area and apparent diffusion coefficient (ADC) were measured. After treatment (within 1 month after radiotherapy and chemotherapy), MRI was performed again, the residual tumor area and ADC value were measured, and the tumor remission rate was calculated. To analyze the correlation between ADC value and tumor remission rate before and after treatment, and to analyze the difference of ADC values and changes between complete remission patients (CR group) and non-CR patients (non-CR group) before and after treatment. Results the tumor area of 25 patients with hypopharyngeal carcinoma was 4.81 (0.834.12) cm ~ (-2) before treatment, and 2.42 (07.92) cm ~ (-2) after treatment. The tumor remission rate was 74.8% (6.0 / 100%), and 11 (11 / 25) / 44.0% of the patients disappeared after treatment. There was a negative correlation between the mean ADC value and the highest ADC value before and after treatment (r = 0.922, P < 0.05), and a positive correlation between the mean ADC value and the remission rate after treatment (r = 0.678%, P < 0.05), and the mean value of ADC in the non-CR group before treatment was significantly higher than that in the control group (P < 0.05). The highest ADC value in CR group was higher than that in CR group after treatment, and the change of mean ADC value before and after treatment was higher than that in non-CR group (P < 0.05). Conclusion the changes of ADC values before and after treatment may be useful in evaluating the early remission rate of nonoperative hypopharyngeal carcinoma after radiotherapy and chemotherapy.
【作者单位】：中国人民解放军总医院放射诊断科;解放军总医院第一附属医院放射科;
【分类号】：R445.2;R739.6

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