表观扩散系数在乳腺癌肝转移早期疗效评价中的进一步探究  

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

作　　者：朱艳[1] 陆洋[1] 王娅婷[1] 刘艳[1] 朱波[1] 徐青青[1] 陈伟[1] 柏根基[1] ZHU Yan LU Yang WANG Yating et al(Department of Imaging,the First Pople＇s Hospital of Huaian,Affiliated to Nanjing Medical University, Huaian 223300, P. R. Chin)

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》2017年第2期187-191,共5页Journal of Clinical Radiology

摘　　要：目的应用表观扩散系数(ADC)早期评价乳腺癌肝转移(BCLMs)化疗效果。方法搜集19例(共42个转移灶)乳腺癌肝转移患者资料,10例单用蒽环类治疗,9例采用蒽环联合紫衫类联合治疗。于化疗前3~4天,化疗后1周,化疗后2周及化疗后1个月行MRI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)于化疗4周后划分有效组与无效组。结果在42个转移灶中,有效组有11个,无效组共31个,有效组化疗前后ADC值分别为(0.9±0.16)×10^(-3)mm^2/s,(1.05±0.12)×10^(-3)mm^2/s,(1.26±0.12)×10^(-3)mm^2/s,(1.33±0.87)×10^(-3)mm^2/s;化疗前有效组与无效组的ADC值分别为(0.9±0.16)×10^(-3)mm^2/s,(1.09±0.24)×10^(-3)mm^2/s,F=1.790,P<0.05。绘制ROC曲线,化疗后2周,曲线下面积为0.782其可信区间为64.5%~91.8%,具有较高的临床诊断价值,取ADC=1.14×10^(-3)mm^2/s作为判断化疗有效与否的临界点。结论 ADC可于化疗后2周定量判断BCLMs疗效。Objective To evaluate the role of apparent diffusion coefficient（ ADC） in predicting early response of breast cancer liver metastases（ BCLMs） after chemotherapy. Methods Nineteen patients with 42 lesions of liver metastases from breast cancer were included. Ten of them received Anthracyclines and the others received Anthracyclines plus Paclitaxel drugs,and all of them were examined by diffusion-weighted MRI at four times（ 3- 4 days before chemotherapy,1week after chemotherapy,two weeks after chemotherapy and four weeks after chemotherapy） and ADC values were measured at the same time. RECIST was utilized to distinguish responders from non-responders. Results In all the lesions,11 lesions were responders and 31 lesions were non-responders. A statistical significant correlation was found between prechemotherapy and post-chemotherapy ADC values in responders,which were（ 0. 9 ± 0. 16） × 10-3mm2/ s,（ 1. 05 ± 0. 12）× 10-3mm2/ s,（ 1. 26 ± 0. 12） × 10-3mm2/ s,（ 1. 33 ± 0. 87） × 10-3mm2/ s,respectively. The mean ADC values of responders and non-responders before chemotherapy were（ 0. 9 ± 0. 16） × 10-3mm2/ s,（ 1. 09 ± 0. 24） × 10-3mm2/ s,F =1. 790,P 〈 0. 05,respectively. An ADC value 1. 14 × 10-3mm2/ s was chosen as the cutoff to assess for efficacy after chemotherapy by ROC curves. The corresponding areas under the curve were 0. 678,and the 95% confidence interval was64. 5%- 91. 8%. Conclusion The ADC values can predict the response of BCLMs two weeks after chemotherapy 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]