表观扩散系数在乳腺癌肝转移早期疗效评价中的应用  

Early Evaluation of Breast Cancer Liver Metastases Response by Apparent Diffusion Coefficient

作　　者：朱艳[1] 陆洋[1] 王娅婷[1] 柏根基[1] 

机构地区：[1]南京医科大学附属淮安第一医院影像科,淮安223300

出　　处：《临床放射学杂志》2015年第7期1097-1101,共5页Journal of Clinical Radiology

摘　　要：目的应用表观扩散系数（ADC）值预测和早期评价乳腺癌肝转移（BCLMs）化疗效果。方法搜集40例乳腺癌肝转移患者,共69个转移灶,均行多西他赛联合卡培他滨（TX）化疗方案,于化疗前3~4天和化疗后1个月行普通平扫及扩散加权成像（DWI）并测定ADC值。采用实体瘤疗效评价标准（RECIST）划分有效组与无效组。结果在69个转移灶中,31个病灶有效,38个病灶无效,化疗前后ADC值分别为（1.26±0.35）×10^-3mm^2/s和（1.37±0.32）×10^-3mm2^/s（t=3.468,P〈0.05）;有效组与无效组化疗前ADC值分别为（1.16±0.24）×10^-3mm^2/s和（1.35±0.44）×10^-3mm^2/s（t=2.142,P〈0.05）;有效组与无效组化疗后ADC值分别为（1.46±0.30）×10^-3mm^2/s和（1.31±0.34）×10^-3mm^2/s（t=1.647,P〉0.05）;有效组化疗前后ADC值分别为（1.16±0.24）×10^-3mm^2/s和（1.46±0.30）×10^-3mm^2/s（t=9.881,P〈0.000）;无效组化疗前后ADC值分别为（1.35±0.44）×10^-3mm^2/s和（1.31±0.34）×10^-3mm^2/s（t=1.341,P〉0.05）;绘制受试者工作特征（ROC）曲线,约登指数=1.27,b值为700时,取ADC=1.37×10^-3mm^2/s作为判断化疗是否有效的界值,曲线下面积（AUC）：0.678,95%可信区间（CI）：55%~83%。结论 ADC值可以早期定量预测BCLMs化疗效果。Objective To evaluate the role of apparent diffusion coefficient（ADC） in predicting response of breast cancer liver metastases（BCLMs） after chemotherapy.Methods Forty patients with 69 lesions of liver metastases from breast cancer who all received docetaxel plus capecitabine（TX） were examined by diffusion-weighted MRI twice（3-4days before chemotherapy and 1months after chemotherapy） and the ADC values were also measured at the same time.RECIST was utilized to distinguish responders from non-responders.Results In all the lesions,31 lesions were responders and 38 lesions were nonresponders.A statistical significant correlation was found between pre-chemotherapy and post-chemotherapy ADC values,which were（1.26 ± 0.35） × 10^-3mm^2/ s,（1.37 ± 0.32） × 10^-3mm^2/ s（t = 3.468,P 0.05）,respectively.The mean ADC values of responders and non-responders were（1.16 ± 0.24） × 10^-3mm^2/ s,（1.35 ± 0.44）× 10^-3mm^2/ s（t = 2.142,P 0.05） respectively before chemotherapy.After the treatment,the mean ADC values of responders and non-responders were（1.46 ± 0.30） × 10^-3mm^2/ s,（1.31 ± 0.34） × 10^-3mm^2/ s（t = 1.647,P 0.05）,respectively.In the responders group,the mean ADC values were（1.16 ± 0.24） × 10^-3mm^2/ s,（1.46 ± 0.30） × 10^-3mm^2/ s（t = 9.881,P 0.000） before and after chemotherapy,respectively.In the non-responders group,the mean ADC values were（1.35 ± 0.44） × 10^-3mm^2/ s 和（1.31 ± 0.34） × 10^-3mm^2/ s（t = 1.341,P 0.05） respectively before and after chemotherapy.We Chose ADC value equal to 1.37 × 10^-3mm^2/ s which was the cutoff to evaluate efficacy after chemotherapy by ROC curves.The corresponding areas under the curve were 0.678,and the 95% confidence interval is 55%-83%.Conclusion The ADC values can predict the response of chemotherapy earlier and quantitatively.

关 键 词：乳腺癌肝转移 表观扩散系数 化学治疗 

分 类 号：R445.2[医药卫生—影像医学与核医学] R737.9[医药卫生—诊断学]