扩散加权成像表观扩散系数预测鼻咽癌同步放化疗疗效

发布时间：2018-05-24 15:31

本文选题：鼻咽肿瘤 + 扩散磁共振成像　；参考：《中国医学影像技术》2014年07期

【摘要】：目的探讨DWI中ADC值预测鼻咽癌同步放化疗疗效的价值。方法收集经病理证实并于我院接受同步放化疗的鼻咽癌患者65例,于治疗前行MRI及DWI,测量肿瘤平均、最高及最低ADC值,于治疗中(放疗剂量达50Gy)、治疗末再次行MRI,计算肿瘤消退率。分析治疗前肿瘤ADC值与肿瘤消退率的相关性;比较治疗末完全缓解(CR)患者及非CR患者治疗前ADC值差异;绘制ROC曲线,评估治疗前ADC值预测疗效的效能。结果治疗前肿瘤平均ADC值、最高ADC值与治疗中消退率呈负相关(r=-0.463、-0.552,P均0.001)、与治疗末消退率呈负相关(r=-0.504、-0.481,P均0.001);CR患者及非CR患者治疗前平均ADC值分别为(0.98±0.12)×10-3 mm2/s及(1.14±0.13)×10-3 mm2/s,最高ADC值分别为(1.16±0.21)×10-3 mm2/s及(1.42±0.23)×10-3 mm2/s,CR与非CR患者治疗前平均及最高ADC值差异均有统计学意义(P均0.001)。以肿瘤治疗前平均ADC值1.09×10-3 mm2/s为界值,其预测同步放化疗后CR的敏感度、特异度及准确率分别为82.5%、76.0%及80.0%,曲线下面积为0.816。结论治疗前肿瘤平均及最高ADC值可预测鼻咽癌放化疗疗效,有望为个体化治疗鼻咽癌提供依据。
[Abstract]:Objective to evaluate the value of ADC in DWI in predicting the efficacy of simultaneous radiotherapy and chemotherapy in nasopharyngeal carcinoma (NPC). Methods Sixty-five patients with nasopharyngeal carcinoma confirmed by pathology and received simultaneous radiotherapy and chemotherapy in our hospital were collected. MRI and DWI were measured before treatment and the mean, highest and lowest ADC values were measured. MRI was performed again at the end of the treatment (radiotherapy dose was 50 Gy), and tumor regression rate was calculated. To analyze the correlation between tumor ADC value and tumor regression rate before treatment, to compare the difference of ADC between patients with complete remission and non-CR before treatment, and to draw ROC curve to evaluate the efficacy of ADC value in predicting curative effect before treatment. Results the mean ADC value of tumor before treatment, There was a negative correlation between the highest ADC value and the extinction rate in treatment, and the average ADC value before treatment for CR patients and non-CR patients was 0.98 卤0.12) 脳 10-3 mm2/s and 1.14 卤0.13) 脳 10-3 mm2s, respectively, and the highest ADC values were 1.16 卤0.21 脳 10-3 mm2/s and 1.42 卤0.23) 脳 10-3mm2s-1 for CR patients and 1.42 卤0.23 脳 10-3 mm ~ 2s for non-CR patients, respectively, and the highest ADC values were 1.16 卤0.21 脳 10-3 mm2/s and 1.42 卤0.23 脳 10-3 mm / s, respectively. There were significant differences in average and highest ADC values before treatment (P = 0.001). The average ADC value before treatment was 1.09 脳 10 -3 mm2/s. The sensitivity, specificity and accuracy of predicting CR after concurrent radiotherapy and chemotherapy were 82.5% and 80.0%, respectively. The area under the curve was 0.816. Conclusion the mean and highest ADC values of nasopharyngeal carcinoma before treatment can predict the curative effect of radiotherapy and chemotherapy of nasopharyngeal carcinoma, which may provide evidence for individualized treatment of nasopharyngeal carcinoma.
【作者单位】：中国医学科学院肿瘤医院肿瘤研究所影像诊断科;
【分类号】：R445.2;R739.63

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