3.0T磁共振多b值扩散加权成像在中央型肺癌伴肺不张化疗效果评估中的价值  

Value of 3.0T magnetic resonance multi-b value diffusion-weighted imaging in efficacy evaluation of chemotherapy for central lung cancer with atelectasis

作　　者：侯丽娜[1] 张建新[1] 杜笑松[1] 赵致楷[1] 辛磊[1] 边泽宇 郑芳[1] 王秀云[1] 杨晓棠[1] Hou Lina Zhang Jianxin Du Xiaosong Zhao Zhikai Xin Lei Bian Zeyu Zheng Fang Wang Xiuyun Yang Xiaotang(Department of MR/CT, Shanxi Cancer Hospital, Taiyuan 030013, China Department of Medical Imaging, Shanxi Medical University, Taiyuan 030001, Chin)

机构地区：[1]山西省肿瘤医院MR/CT室,太原030013 [2]山西医科大学医学影像学系,太原030001

出　　处：《肿瘤研究与临床》2017年第5期308-312,共5页Cancer Research and Clinic

基　　金：山西省科技攻关项目（20130313021-4）

摘　　要：目的 探讨3.0T磁共振多b值扩散加权成像（DWI）在中央型肺鳞状细胞癌伴肺不张患者化疗效果评估中的价值.方法 对20例肺鳞状细胞癌患者在化疗前、化疗2个周期和4个周期时行磁共振成像（MRI）扫描（包括T1WI、T2WI和多b值DWI）,分析图像并且比较肿瘤体积和多b值表观弥散系数（ADC）的变化.结果 中央型肺癌伴肺不张患者化疗前在MRI检查中可以区分瘤体和肺不张,放疗后在T2WI图像上更加容易鉴别.20例患者中,有效组（部分缓解或完全缓解）和无效组ADC值均增大,但有效组化疗前、化疗2个周期和4个周期时的ADC值差异有统计学意义[b=800 s/mm2：（1.09±0.52）×10^-6 mm2/s、（1.22±0.59）×10^-6 mm2/s、（1.24±0.52）×10^-6 mm2/s,F=31.19,P〈0.001],无效组化疗前后ADC值差异无统计学意义[b=800 s/mm2：（1.10±0.49）×10^-6 mm2/s、（1.16±0.60）×10^-6 mm2/s、（1.20±0.72）×10^-6 mm2/s,F=2.86,P=0.089].b=800 s/mm2时,有效组ADC变化曲线斜率更稳定、 线性更好.结论 MRI技术可以准确区分化疗前后的肿瘤和肺不张;化疗后平均ADC值的变化早于形态学改变;适合b值的变化率可在一定程度上更好地评估化疗效果.Objective To evaluate the value of 3.0T magnetic resonance multi-b value diffusion-weighted imaging （DWI） in evaluating the efficacy of chemotherapy for patients with central lung squamous cell carcinoma and atelectasis. Methods Twenty patients with lung squamous cell carcinoma were examined by magnetic resonance imaging （MRI） （including T1WI, T2WI and multi-b value DWI） before chemotherapy, 2 cycles of chemotherapy and 4 cycles of chemotherapy. The images, the tumor volume and changes of apparent diffusion coefficient （ADC） were analyzed. Results In the patients with central lung cancer and atelectasis, the tumor and atelectasis could be distinguished on MRI examination before radiotherapy. It was more easily identified on T2WI images after radiotherapy. In the 20 patients, the ADC values in the effective group （partial remission or complete remission） and the invalid group were increased, but the differences of ADC values in the effective group before chemotherapy, 2 cycles and 4 cycles of chemotherapy were statistically significant [b=800 s/mm2：（1.09 ± 0.52） × 10^-6 mm2/s, （1.22 ± 0.59） × 10^-6 mm2/s, （1.24 ± 0.52） × 10^-6 mm2/s, F = 31.19, P 〈 0.001]. There was no significant difference in ADC values between before and after chemotherapy （b = 800 s/mm2： （1.10 ± 0.49） × 10^-6 mm2/s, （1.16 ± 0.60） × 10^-6 mm2/s, （1.20 ± 0.72） × 10^-6 mm2/s, F=2.86, P=0.089]. When b=800 s/mm2, the ADC curve slope in the effective group was more stable, better linearity. Conclusions The MRI technique can accurately distinguish the tumor from atelectasis before and after chemotherapy. The change of ADC value after chemotherapy is earlier than that of morphological change. The change rate of b value can better evaluate the curative effect of chemotherapy.

关 键 词：肺肿瘤 肺不张 磁共振成像 多b值扩散加权成像 药物疗法  联合 

分 类 号：R445.2[医药卫生—影像医学与核医学] R734.2[医药卫生—诊断学]