DCE-MRI定量参数及ADC值在局部进展期胃癌新辅助治疗疗效评价的应用  

Application of DCE-MRI quantitative parameters and ADC values in evaluating the efficacy of neoadjuvant therapy for locally advanced gastric cancer

作　　者：徐校胜 时高峰[1] 杨丽[1] 魏佳 XU Xiaosheng;SHI Gaofeng;YANG Li;WEI Jia(CT/MR Room,the Fourth Hospital of Hebei Medical University,Shijiazhuang 050000,China)

机构地区：[1]河北医科大学第四医院CT/MR室,河北石家庄050000

出　　处：《实用放射学杂志》2021年第1期132-136,共5页Journal of Practical Radiology

摘　　要：目的探讨动态对比增强磁共振成像(DCE-MRI)及扩散加权成像(DWI)对局部进展期胃癌新辅助放化疗(NACR)后疗效评价的临床应用价值.方法选取25例局部进展期胃癌病例,测量肿瘤动态对比增强(DCE)定量参数容量转移常数变化值(ΔKtrans)、血管外细胞外间隙容积比变化值(ΔKep)、速率常数变化值(ΔVe)及表观扩散系数变化值(ΔADC).术后肿瘤退缩分级(TRG)分为0,1,2,3级.应用Spearman检验分析各参数变化值与TRG的相关性.应用独立样本t检验或Mann-WhitneyU检验分析2组间ΔKtrans、ΔKep、Δve及ΔADC值的差异性;再制作受试者工作特征(ROC)曲线,进一步分析最佳诊断效能值.P<0.05认为有统计学差异.结果有效组治疗后ΔKtrans、ΔADC大于无效组,差异有统计学意义(P<0.05).ΔKtrans、ΔKep与TRG之间呈负相关(r=-0.554,P=0.009;r=-0.599,P=0.004).ΔADC与TRG之间呈正相关(r=0.603,P=0.005).做ROC曲线,曲线下面积(AUC)为0.754,当ΔKtrans>0.0075min^(-1)时,预测胃癌NACR有效的诊断准确率为80%,敏感性为92.9%,特异性为55.6%.做ΔADC的ROC曲线,AUC为0.857,当ΔADC绝对差值>0.406×10^(-3) mm^(2)/s时,预测胃癌NACR有效的准确率为76%,敏感性为100%,特异性为71.4%.结论DCEGMRI的ΔKtrans及DWI的ΔADC值可以作为局部进展期胃癌NACR后疗效评价方法.Objective To assess the value of dynamic contrast-enhanced magnetic resonance imaging(DCE-MRI)and diffusion weighted imaging(DWI)in evaluating the efficacy of neoadjuvant chemoradiation(NACR)for locally advanced gastric cancer.Methods T wenty-five patients with locally advanced gastric cancer were enrolled.The dynamic contrast-enhanced(DCE)quantitative parameters ΔKtrans、ΔKep、Δve and ΔADC were measured.The postoperative tumor regression grade(TRG)was divided into0,1,2,3 grade.S pearman test was used to analyze the correlation between the quantitative parameters and TRG.The independent sample t test and Mann-Whitney U test and receiver operating characteristic(ROC)analysis were performed.P<0.05 was considered statistically significant.Results Negative correlations were found between ΔKtrans and ΔKep and TRG(r=-0.554,P=0.009;r=-0.599,P=0.004),and positive correlation was found between OADC and TRG(r=0.603,P=0.005).After treatment,the changes of Ktrans and ADC in the effective group were significantly higher than that in ineffective group(P<0.05).In the analysis of ROC,area under the curve(AUC)were 0.754 and 0.857 for ΔKtrans and △ADC.The accuracy,sensitivities and specificities were 80%,92.9%and 55.6% for ΔKtrans(cut-off value:0.0075 min^(-1)),respectively,and those for △ADC were 76%,100%and 71.4%(cut-off value:0.406×10^(-3) mm^(2)/s),respectively.Conclusion The ΔKtrans of DCE-MRI and the △ADC value of DWI can be used as a method for evaluating the efficacy of NACR for locally advanced gastric cancer.

关 键 词：进展期胃癌 新辅助放化疗 动态对比增强磁共振成像 疗效评价 

分 类 号：R735.2[医药卫生—肿瘤] R818.051[医药卫生—临床医学]