3.0T扩散加权成像表观扩散系数在胰腺癌早期化疗疗效评估中的价值  

Value of Apparent Diffusion Coefficient on 3.0T MR Diffusion-Weighted Imaging in Evaluation of Early Effect of Chemotherapy on Pancreatic Cancer

作　　者：陆海凤[1] 柳勇[1] 单奔 马林[1] 周寒松[1] LU Hai-feng;LIU Yong;SHAN Ben;MA Lin;ZHOU Han-song(Department of Imaging,the Second People’s Hospital of Huaian,Huaian 223002,China)

机构地区：[1]淮安市第二人民医院影像科

出　　处：《南昌大学学报（医学版）》2019年第6期47-50,54,共5页Journal of Nanchang University：Medical Sciences

摘　　要：目的探讨3.0T扩散加权成像表观扩散系数(ADC)在胰腺癌早期化疗疗效评估中的价值。方法对31例胰腺导管上皮腺癌患者行吉西他滨+氟尿嘧啶+顺铂方案化疗。于化疗前2周内、化疗1个月及6个月行常规MRI及扩散加权成像检查,观察肿瘤信号及ADC变化情况。化疗6个月后,按RECIST标准将31例患者分为进展组(14例)及稳定组(17例),比较2组化疗前、化疗1个月后的ADC值。于化疗前、化疗1个月后将31例患者按ADC及ΔADC(化疗前与化疗1个月的ADC差值)中位值分位高、低值组,分析ADC值与患者生存时间的关系。结果进展组化疗前后ADC值比较差异无统计学意义(t=0.15,P=0.883),稳定组化疗后ADC值较化疗前显著升高(t=4.52,P=0.000),进展组ΔADC值明显低于稳定组(t=-3.52,P=0.001)。进展组化疗前与化疗后1个月肿瘤大小比较差异无统计学意义(t=0.44,P=0.668),与治疗后6个月比较差异有统计学意义(t=7.56,P=0.000);稳定组肿瘤大小化疗前与化疗后1、6个月比较差异均无统计学意义(t=1.00,P=0.336;t=0.31,P=0.764)。化疗前ADC及ΔADC高值组生存时间与低值组比较差异均无统计学意义(χ2=0.058,P=0.809;χ2=4.524,P=0.112),化疗1个月后ADC值高值组生存时间较低值组显著增加(χ2=7.618,P=0.006)。结论ADC可作为胰腺癌化疗早期疗效的评价指标,早期ADC值变化与生存率存在相关性。Objective To explore the value of apparent diffusion coefficient(ADC)on 3.0T MR diffusion weighted imaging(DWI)in evaluating the early effect of chemotherapy in patients with advanced pancreatic cancer.Methods Thirty-one patients with pancreatic ductal adenocarcinoma underwent chemotherapy with gemcitabine+fluorouracil+cisplatin.The routine MRI and diffusion-weighted imaging were performed within 2 weeks before treatment and after 1 and 6 months of chemotherapy to observe the changes in tumor signal and ADC.After chemotherapy for 6 months,patients were divided into progressive group(14 cases)and stable group(17 cases)according to the RECIST criteria.ADC values were compared between the two groups before and after treatment for 1 month.Furthermore,patients were divided into high value groups and low value groups according to the median values of ADC andΔADC(difference between the values before and after treatment for 1 month).The relationship between ADC value and survival time was analyzed.Results There was no significant change in ADC value before and after treatment in progressive group(t=0.15,P=0.883).In stable group,the ADC increased after treatment(t=4.52,P=0.000).Compared with stable group,theΔADC decreased in progressive group(t=-3.52,P=0.001).The tumor size was reduced in progressive group after chemotherapy for 6 month(t=7.56,P=0.000),but was not altered after chemotherapy for 1 month(t=0.44,P=0.668).There were no changes in tumor size in stable group after treatment for 1 month(t=1.00,P=0.336),as well as after treatment for 6 months(t=0.31,P=0.764).Before chemotherapy,no significant difference in survival time was observed between high ADC group and low ADC group(χ2=0.058,P=0.809),as well as between highΔADC group and lowΔADC group(χ2=4.524,P=0.112).However,the survival time in high ADC group was longer than that in low ADC group after 1 month of treatment(χ2=7.618,P=0.006).Conclusion The ADC can be used as an index to evaluate the early effect of chemotherapy on advanced pancreatic cancer.There

关 键 词：胰腺癌 扩散加权成像 表观扩散系数 早期疗效 临床价值 

分 类 号：R445[医药卫生—影像医学与核医学]