表观扩散系数在食管癌放化疗效果评估中的应用价值  

Value of apparent diffusion coefficient in evaluation of curative efficay of chemoradiotherapy for esophageal cancer

作　　者：任基伟[1] 张旭婷[1] 靳宏星[1] 张瑞平 尉志红 REN Jiwei;ZHANG Xuting;JIN Hongxing;ZHANG Ruiping;YU Zhihong(Department of MR and CT, Shanxi Province Tumor Hospital, Taiyuan 030013, Shanxi Province, China;Department of Ultrasound, Shanxi Provincial People's Hospital, Taiyuan 030012, Shanxi Province, China)

机构地区：[1]山西省肿瘤医院核磁CT室,山西太原030013 [2]山西省人民医院超声科,山西太原030012

出　　处：《肿瘤影像学》2019年第3期176-181,共6页Oncoradiology

基　　金：山西省卫计委青年课题(2015053)

摘　　要：目的:探讨表观扩散系数(apparent diffusion coefficient,ADC)在食管癌放化疗效果评估中的应用价值。方法:回顾性分析30例经病理学检查证实的食管癌患者,根据实体瘤疗效评价标准(response evaluation criteria in solid tumors,RECIST)分为缓解组与未缓解组,比较两组患者放化疗前后病灶的长度、厚度及ADC值,绘制受试者工作特征(receiver operating characteristic,ROC)曲线,得出相应阈值及诊断灵敏度与特异度。结果:食管癌放疗后病灶的长度、厚度均缩小,ADC值升高。病灶的长度差值和厚度差值及变化率不能作为疗效预测指标,而ADC差值及变化率可作为疗效预测指标。ADC差值为0.630×10^-3mm^2/s,变化率为0.559,两者可作为病变缓解的阈值,其诊断灵敏度和特异度分别为81.3%、85.7%和87.5%、85.7%。结论:扩散加权成像(diffusion weighted imaging,DWI)可用于食管癌患者放化疗效果的评估,通过ADC值可对疗效评价进行量化分析。Objective: To explore the value of apparent diffusion coefficient (ADC) in the evaluation of curative efficay of chemoradiotherapy for esophageal cancer.Methods: A total of 30 cases of pathologically confirmed esophageal cancer were retrospectively analyzed.According to the response evaluation criteria in solid tumors (RECIST),they were divided into remission group and non-remission group.The lesion length,thickness and ADC value before and after chemoradiotherapy were compared.The receiver operating characteristic (ROC) curve was drawn to obtain the corresponding thresholds and diagnostic sensitivity and specificity.Results: The lesion length and thickness were reduced,and ADC values were increased after treatment.The lesion length difference,thickness difference and their variation rates could not be used as predictive indicators of curative efficay,but ADC value difference and variation rate could be used.When the ADC value difference of 0.630×10^-3 mm^2/s and variation rate of 0.559 were set as the thresholds of remission,the sensitivity and specificity achieved 81.3%,85.7%,and 87.5%,85.7%,respectively.Conclusion: Diffusion weighted imaging (DWI) could be used to evaluate chemoradiotherapy efficacy in the patients with esophageal cancer.

关 键 词：食管癌 表观扩散系数 放化疗 疗效评估 

分 类 号：R735.1[医药卫生—肿瘤] R445.2[医药卫生—临床医学]