应用磁共振扩散加权成像早期评价淋巴瘤化疗疗效的研究  

Application of Magnetic Resonance Diffusion Weighted Imaging in Evaluating the Early Efficacy of Chemotherapy for Malignant Lymphoma

作　　者：刘岚[1] 徐仁根[1] 王索宇[1] 周雪春[1] 胡利平[1] 孙美[1] 周锋江[1] 谢恒[1] 

机构地区：[1]江西省肿瘤医院,330029

出　　处：《实用癌症杂志》2015年第12期1815-1817,共3页The Practical Journal of Cancer

基　　金：江西省科技计划项目(编号:20122BBG70106-2)

摘　　要：目的探讨应用MR扩散加权成像(DWI)技术监测肿瘤ADC值变化对早期评价淋巴瘤化疗疗效的价值。方法收集38例经病理检查证实的淋巴瘤患者,分别于化疗前、化疗后半个月(第1、3、5、9、13、15天)及化疗结束时(约30天检查),接受DWI扫描并测量ADC值;同时在化疗前、化疗后第15天、化疗结束时三个时间点增加横轴位T1WI及T2WI扫描以测量肿瘤的最大直径(长径)。按RESIST标准根据肿瘤化疗前、化疗结束时最大直径变化情况将研究病例分为化疗有效组和无效组,分析两组肿瘤化疗早期不同监测时间点ADC值的变化差异。结果化疗有效组从治疗后第9天开始ADC值明显升高,第13天、第15天肿瘤ADC值继续升高,无效组无明显升高,两组间ADC值比较差异有统计学意义。而两组患者化疗后第15天肿瘤直径均无明显变化。结论淋巴瘤化疗后肿瘤ADC值变化早于其形态学的改变,应用DWI技术监测肿瘤ADC值变化可作为早期评估淋巴瘤疗效的有效手段。Objective To study the value of MR diffusion-weighted imaging（ DWI） in monitoring change of ADC value in the early evaluation of efficacy of lymphoma treated with chemotherapy.Methods 38 cases of lymphoma patients confirmed by pathology received DWI and ADC value were measured before chemotherapy,half month after the beginning of chemotherapy（1, 3,5,9,13,15 d） and at the end of chemotherapy（30 d）.Before chemotherapy,15 d after the beginning of chemotherapy and at the end of chemotherapy,horizontal T1 WI and T2 WI scan were conducted to measure the maximum tumor diameter.According to the maximum tumor diameter by RESIST standard before chemotherapy and at the end of chemotherapy,the patients were divided into chemotherapy effective group and chemotherapy ineffective group.The changes of ADC value at different monitoring points in the early treatment of chemotherapy were analyzed.Results In the chemotherapy effective group, ADC value significantly in-creased 9 d after the beginning of chemotherapy,13 d ,15 d after the beginning of chemotherapy ADC value kept increasing.ADC value of the chemotherapy ineffective group had no significant increase.There had significant difference in ADC value between the 2 groups.15 d after the beginning of chemotherapy,the maximum tumor diameter of 38 cases had no significant change.Conclu-sion The change of ADC value are earlier than morphological changes in lymphoma treated with chemotherapy.DWI in monito-ring changes of ADC value can be effective measurement in the early evaluation of efficacy of lymphoma.

关 键 词：淋巴瘤 扩散加权成像 表观弥散系数 

分 类 号：R733.4[医药卫生—肿瘤]