DWI在听神经瘤伽玛刀治疗后早期疗效评估中的价值  

Diffusion Weighted Imaging in Assessment of the Early Response of Acoustic Neuroma Treated by Gamma Knife Radiosurgery

作　　者：丁建[1] 戴嘉中[1] 曹文静[1] 施惠东[1] 江华[1] 吴丽琼[1] 于同刚[1] 

机构地区：[1]复旦大学附属华山医院,上海伽玛医院放射科

出　　处：《中国医学计算机成像杂志》2017年第4期299-302,共4页Chinese Computed Medical Imaging

摘　　要：目的:观察听神经瘤伽玛刀治疗前后ADC值的变化特点,探讨磁共振扩散加权成像(DWI)在评估听神经瘤伽玛刀治疗后早期疗效中的价值。方法:62例听神经瘤患者,其中,男性38例,女性24例,年龄23~78岁,平均年龄45.3±5.9岁。采用医科达公司Leksell伽玛刀,处方剂量为12~13Gy(中心剂量24~27Gy)。所有患者在治疗前及治疗后8个月均行常规MRI及DWI检查,并采用Functool 9.4.05a软件计算肿瘤体积、表观扩散系数(ADC)值及指数化表观扩散系数(e ADC)值。结果:62个采用伽玛刀治疗的听神经瘤病灶,30例(48.4%)肿瘤稳定,21例(33.9%)体积增大,11例(17.7%)体积缩小。其治疗前体积、ADC及e ADC值分别为5.052±2.995cm3、(1.374±0.681)×10^(-3)mm^2/s和0.289±0.063;而伽玛刀治疗后8个月分别为5.281±3.375cm3、(1.658±0.340)×10^(-3)mm^2/s和0.224±0.088。采用配对样本t检验进行统计学分析发现,结果显示治疗前后体积的变化无统计学差异(t=-1.100,P=0.275),ADC值(t=-3.021,P=0.004)及e ADC值(t=5.502,P=0.000)的变化均有显著统计学差异。结论:磁共振扩散加权成像(DWI)在听神经瘤伽玛刀治疗后早期疗效评估中有一定价值,ADC及e ADC值可以早期提示肿瘤对治疗的反应。Purpose： To observe the changes of ADC values and explore the clinical value of diffusion-weighted MR imaging （DWI） in assessment of early response in acoustic neuroma treated by Gamma Knife radiosurgery. Methods： We collected 62 patients （38 men and 24 women） with ages ranged from 23-78 years and a mean age of 45.3±5.9 years. All the patients were treated by Gamma Knife radiosurgery （Leksell Gamma Knife, Elekta） with prescribed dose 12-13Gy and central dose 24-27Gy. The conventional MRI and DWI examinations were undergone before and eight months after Gamma Knife treatment. Tumor volume, ADC and eADC values were analyzed and compared via supporting workstation processing software （Functool 9.4.05a）. Results： The tumor size was stable in 30 patients（48.4%）, was increased in 21 patients （33.9%）, and was decreased in 11 patients （17.7%）. Tumor volume, ADC and eADC values were 5.052±2.995 cm3,（1.374±0.681）×10-3mm2/s and 0.289±0.063 respectively before treatment, and 5.281±3.375cm3,（1.658±0.340）×10-3mm2/s and 0.224±0.088 respectively eight months after treatment. The changes of tumor volume was not with statistical significant difference by using paired sample t-test（t=- 1.100,P=0.275）, while the changes of ADC and eADC value were with statistical significant difference （t=- 3.021,P=0.004; t=-5.502,P=0.000, respectively）. Conclusion： DWI is meaningful in evaluating the early response in acoustic neuroma treated by Gamma Knife radiosurgery and helpful to predict treatment response.

关 键 词：扩散加权成像 听神经瘤 伽玛刀 立体定向放射外科 

分 类 号：R445.2[医药卫生—影像医学与核医学] R739.4[医药卫生—诊断学]