应用DWI和DTI技术评估胶质母细胞瘤术后替莫唑胺标准放化疗后早期进展的初步研究  被引量:2

Primary study for the value of DWI and DTI in the detection of early progression for postoperative glioblastona with standard temozolomide chemoradiotherapy

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作  者:倪春霞[1,2] 汪洋[1,2] 盛晓芳[1,2] 孟歌[1,2] 陈淑[1,2] 于同刚[1,2,1,3] 丁建[1,3] 江华[1,3] 戴嘉中[1,3] 潘力[1,4] 

机构地区:[1]复旦大学附属华山医院 [2]上海伽玛医院肿瘤放疗中心,上海200235 [3]上海伽玛医院放射科,上海200235 [4]上海伽玛医院神经外科,上海200235

出  处:《立体定向和功能性神经外科杂志》2015年第2期97-101,共5页Chinese Journal of Stereotactic and Functional Neurosurgery

基  金:上海市卫计委科研课题;(编号:20134438)

摘  要:目的初步探讨利用MRI扩散加权成像(DWI)和弥散张量成像(DTI)评估胶质母细胞瘤(GBM)术后替莫唑胺(TMZ)标准放化疗后早期进展的临床价值。方法观察我院收治GBM术后残留并行TMZ标准放化疗的患者在TMZ同步放化疗前后DWI和DTI的影像学表现,测量残留肿瘤ADC平均值、ADC最小值、FA平均值和FA最小值,计算放疗前后ADC值和FA值的变化率,记录肿瘤早期进展病例,初步评价各项参数预测GBM患者早期进展的临床价值。结果 2013年12月至2014年7月之间,42例患者入组,早期进展12例。所有病例在TMZ同步放化疗结束时ADC值均有升高,在早期进展组中差异无统计学意义,在无早期进展组中差异有统计学意义。ADC最小值在放化疗前后的变化率在两组间差异有统计学意义。放疗结束时的FA值比放疗前轻度升高,但差异无统计学意义,FA值变化率在两组间差异无统计学意义。结论 TMZ同步放化疗前后的ADC值和ADC最小值变化率有助于判断GBM术后残留肿瘤接受TMZ标准放化疗后的早期进展,值得进一步研究。Objective To analyze the value of DWI and DTI in the evaluation of early progression for glioblastoma(GBM)with standard temozolomide(TMZ)chemoradiation.MethodsThe postoperative GBM with residual tumor who received standard TMZ chemoradiotherapy was included in this prospective study.All patients were performed DWI and DTI pre- and postconcomitant chemoradiotherapy.The average and minimum of ADC and FA were measured.The change rate of ADC and FA were calculated.The cases with early progression were recorded.Results From Dec.2013 to Jul.2014,42 patients were included,with 12 had early progression.The average and minimum ADC value was elevated at the completion of concomitant chemoradiotherapy and the data showed significant difference in progression-free group and no significant difference in the progression group.The change rate of ADC minimum showed significant difference between the two groups.But FA value had none significant difference in each group.Conclusion The ADC value and the change rate of minimum ADC could help identify the early progression for GBM with standard TMZ chemoradiotherapy,which deserve further study.

关 键 词:胶质母细胞瘤 扩散加权成像 弥散张量成像 放射疗法 化学疗法 替莫唑胺 

分 类 号:R739.41[医药卫生—肿瘤]

 

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