动态增强MRI在晚期非小细胞肺癌同步放化疗疗效的评价  

Study on the Value of 3.0T MR Quantitative Dynamic Contrast-enhanced MRI in Predicting the Efficacy of Concurrent Radiotherapy and Chemotherapy for Locally Advanced NSCLC

作　　者：李丁丁[1] 郑香[1] 付敬华 史利红[1] 张文艳 钟洪波[1] LI Ding-ding;ZHENG Xiang;FU Jin-hua(Department of Magnetic Resonance Room,Tangshan People's Hospital,Tangshan 063000,Hebei Province,China)

机构地区：[1]唐山市人民医院磁共振室,河北唐山063000 [2]唐山市人民医院CT室,河北唐山063000

出　　处：《中国CT和MRI杂志》2020年第12期64-67,83,共5页Chinese Journal of CT and MRI

摘　　要：目的探究3.0T MR定量动态增强MRI预测局部晚期NSCLC同步放化疗疗效的价值。方法收集我院经病理学证实,未接受过治疗的局部晚期NSCLC患者共104例,对所有入组患者,采取GE Signa HDx 3.0T MR扫描仪分别在治疗前、治疗第15天、1个月和2个月进行MR常规扫描以及DWI检查,42例进行MDCE-MRI扫描。通过ADW 4.3工作站测量不同检查时间点相应半定量参数值。根据治疗结束后肿瘤最大径表进化,并将病例分为完全缓解(CR)组和部分缓解(PR)组。对比不同分组治疗前、后参数变化差异。结果与治疗前相比,治疗后1个月、2个月后肿瘤最大径较小(P<0.05);治疗后15天至治疗后2个月ADC、EADC、MTE、TTP、NEI值逐渐升高,MSI值逐渐降低(P<0.05);与治疗前相比,治疗后15天、1个月MSD较低,治疗后2个月MSD较高(P<0.05)。与PR组相比,CR组ADC值较低(P<0.05),两组EADC无差异(P>0.05);与治疗前相比,治疗后两组ADC值较高,EADC值较低(P<0.05)。治疗后15天,CR组与PR组的ADC值及EADC值比较(P<0.05)。与治疗前相比,治疗后15天、1个月及2个月两组MTE、TIP、MSD、NEI增高,MSI降低(P<0.05);与PR组相比,各阶段CR组MTE、TIP、MSD以及NEI较低,MSI较高(P<0.05)。结论定量动态增强MRI对评价及预测局部晚期NSCLC同步放化疗疗效具有显著的临床价值。Objective To explore the value of 3.0T MR quantitative dynamic contrastenhanced MRI in predicting the efficacy of concurrent radiotherapy and chemotherapy for locally advanced NSCLC.Methods A total of 104 patients with locally advanced NSCLC1 who were confirmed by pathology in our hospital prepared for radiotherapy and chemotherapy were collected.All patients were scanned with GE Signa HDx 3.0 TMR scanner before treatment,15 days,1 month and 2 months after treatment,and 42 patients were scanned with MDCE-MRI.The corresponding semi-quantitative parameters at different checkpoints were measured by ADW 4.3 workstation.The differences of parameters before and after treatment in different groups were compared.Results Compared with before treatment,there was no significant difference in the maximum diameter of tumors on the 15th day after treatment(P>0.05).The maximum diameter of tumors was lower 1 month and 2 months after treatment(P<0.05);ADC,EADC,MTE,TTP,NEI increased gradually and MSI decreased gradually from the 15th day to the 2nd month after treatment(P<0.05);MSD was lower on the 15th day and 1 month after treatment than before treatment.MSD was higher in the latter two months(P<0.05).Compared with PR group,ADC value of CR group was lower(P<0.05),EADC of two groups had no difference(P>0.05);ADC value of two groups after treatment was higher and EADC value was lower(P<0.05).The ADC and EADC values of CR group and PR group were compared 15 days after treatment(P<0.05).Compared with pretreatment,MTE,TIP,MSD and NEI increased and MSI decreased in both groups at 15,1 and 2 months after treatment(P<0.05);MTE,TIP,MSD and NEI were lower and MSI was higher in CR group than in PR group at all stages(P<0.05).Conclusion Quantitative dynamic contrast-enhanced MR imaging at 3.0T has significant clinical value in evaluating and predicting the efficacy of concurrent radiotherapy and chemotherapy for locally advanced NSCLC,which is suitable for clinical application.

关 键 词：磁共振成像 晚期非小细胞肺癌 同步放化疗 疗效 

分 类 号：R734.2[医药卫生—肿瘤]