磁共振弥散加权成像在食管癌放疗疗效中的应用以及评价价值  

Application of DWI in precise radiotherapy and evaluation of the effect in esophageal carcinoma

作　　者：刘辉[1] 时高峰[1] 邵娴[2] 许茜[1] 贾立涛[1] 翟英敏[1] 

机构地区：[1]河北医科大学第四医院CT室,河北石家庄050021 [2]石家庄市第四医院麻醉科,河北石家庄050000

出　　处：《中国现代医学杂志》2014年第22期57-61,共5页China Journal of Modern Medicine

基　　金：河北省卫生厅医学科学研究重点课题(No:20130244)

摘　　要：目的通过观察磁共振弥散加权成像技术在食管癌放疗中ADC值的变化,观察其在放疗疗效中的评价价值。方法收集该院收治的食管癌患者43例,放疗前行食管钡餐造影、食管镜检查以及CT扫描,并且在放射治疗前1天以及放射治疗结束时行MRI扫描和DWI扫描,CR为食管病变及淋巴结高信号均消失,PR为食管病变或者淋巴结高信号始终未消失,比较采集图像的各项指标以及ADC值。结果 MRI弥散加权成像显示的食管病变长度与食管钡餐造影长度最为接近,而食管病变最大横径与CT扫描最为接近;放疗前与放疗后的ADC值比较,放疗后的ADC值较放疗前显著升高,差异有显著性;放疗前后,食管病变的长度差异有显著性,I组ADC值较II更高,差异有显著性,且放疗前后的差值I组较II组大;MRI弥散加权成像疗效评价为,CR 30例,PR 12例,造影患者放疗后的ADC值高于磁共振患者。结论 DWI显示的病变长度与食管钡餐造影结果最为接近,通过比较正常食管与病变组织的ADC值可以早期对食管癌放疗疗效进行评价并为预后的推断提供信息。[Objective] To explore the applization of DWI in esophageal carcinoma by comparing the value of ADC before and after radiotherapy. [Methods] 43 patients took X-ray double-contrast imaging,esophagoscope and CT scan, and all the patients were examined with conventional MRI and DWI before and after radiotherapy and then once a month after radiotherapy. CR represent colnplete remission, PR represent for partial remission. [ Results ] The length of esophagus by DWI was close to the data by X-ray double-contrast imaging, and therewas no significant difference between CT and MRI; The value of AEC after radiotherapy is significant higher, the average ADC value in I group was higher than that in II group; For the assessment of efficacy, there were 30 patients reaching complete remission and 12 patients reaching partial remission. The value of ADC assessed by esophagogram was higher than that of MRI. [ Conclusion] Tumor lengths measured on MRI and esophagogram had the optimal approximation, MRI could provide important clinical information in evaluating the radiotherapy effect and infering prognosis early for esophageal carcinoma.

关 键 词：磁共振弥散加权成像 食管癌 放射疗法 疗效 

分 类 号：R735.1[医药卫生—肿瘤]