3.0T磁共振扩散加权成像评估进展期直肠癌新辅助放化疗疗效  

Diffusion-weighted 3.0 Tesal MR to predict the response of neoadjuvant chemoradiation therapy in locally advanced rectal cancer

作　　者：王琪璠 张修石[1] 张红霞[1] 于秋杰[1] 

机构地区：[1]哈尔滨医科大学附属肿瘤医院医学影像中心,黑龙江哈尔滨150081

出　　处：《中国医学影像技术》2014年第12期1879-1883,共5页Chinese Journal of Medical Imaging Technology

基　　金：科技创新人才研究专项资金项目(2010RFXQS027)

摘　　要：目的探讨应用3.0T MR DWI评价进展期直肠癌新辅助放化疗疗效的价值。方法回顾分析54例接受新辅助放化疗的进展期直肠癌患者影像资料。所有患者均经术后病理证实为直肠癌且术前MR分期为T3、T4期;均于新辅助放化疗前及治疗后术前1周接受DWI联合常规MR序列扫描;根据Dworak＇s肿瘤消退分级标准,其中敏感组（TRG3～4级）21例（21/54,38.89%）、不敏感组（TRG 0～2级）33例（33/54,61.11%）。测量直肠癌病变区治疗前后长度、厚度及ADC值,计算治疗前后的差值（Δ长度、Δ厚度、ΔACD）及变化率（长度%、厚度%、ACD%）。结果 54例患者新辅助放化疗后病变区较治疗前长度缩短、厚度减低、ADC值升高（P均〈0.01）。新辅助放化疗后敏感组ADC值、ΔADC值及ADC%均高于不敏感组（P均〈0.05）。结论新辅助放化疗对进展期直肠癌有效,治疗后病变区ADC值、ΔADC及ADC%指标对疗效有评价预测作用。Objective To assess the value of 3.0T MR DWI in evaluating neoadjuvant chemoradiation therapy（NCT）efficacy of locally advanced rectal cancer（LARC）.Methods Data of 54 patients with LARC were retrospectively analyzed.All the cases were T3 or T4phase confirmed by postoperative pathology and preoperative MR.DWI combined with conventional scan were performed before NCT and after NCT in 1week before operation.According to Dworak＇s classification,patients were divided into histopathologic responders group（TRG 3—4,n=21,21/54,38.89%）and non-responders group（TRG 0—2,n=33,33/54,61.11%）.The length,thickness and apparent diffusion coefficient（ADC）value of tumor lesion area were measured.Moreover,the difference（Δlength,Δthickness,ΔACD）and rate of change（length%,thickness%,ACD%）of these indexes before and after NCT were severally calculated.Results The length and the thickness of lesion area reduced and the ADC value increased after NCT than those before NCT in all 54cases（all P〈0.01）.The ADC value,ΔADC and ADC%in responders group were higher than those in non-responders group（all P〈0.05）.Conclusion NCT is helpful to the treatment of LARC.The post-NCT ADC,ΔADC and ADC% of lesion area were reliable tool to assess and predict NCT treatment outcome.

关 键 词：直肠肿瘤 新辅助放化疗 扩散磁共振成像 

分 类 号：R735.3[医药卫生—肿瘤] R445.2[医药卫生—临床医学]