磁共振DWI评估周围型非小细胞肺癌化学药物治疗疗效的价值  

The value of diffusion-weighted MR imaging in the evaluation of chemotherapy for peripheral non-smallcelllungcarcinoma

作　　者：王官良[1] 毛海燕[1] 李丽红[1] 李杨飞[1] 米玉成[1] 陈盈[1] 谢继承[1] WANG Guanliang;MAO Haiyan;LI Lihong;LI Yangfei;MI Yucheng;CHEN Ying;XIE Jicheng(Department of Radiology, Taizhou Hospital of Zhejiang Province, Taizhou 317000, P.R.China)

机构地区：[1]浙江省台州医院放射科,浙江台州317000

出　　处：《医学影像学杂志》2021年第8期1330-1333,共4页Journal of Medical Imaging

基　　金：浙江省医药卫生科研面上项目(编号:2018KY891);浙江省台州市科技局A类项目(编号:15yw01)。

摘　　要：目的探讨磁共振弥DWI评估周围型非小细胞肺癌化学药物治疗疗效的价值。方法选取28例经病理证实为非小细胞肺癌并接受首次化学药物治疗的患者,分别于化学药物治疗前1周内、化学药物治疗1周期结束后(化学药物治疗第2周期前2~3天)进行胸部MRI常规及DWI检查。根据RECIST标准,分为部分缓解组(PR)及疾病稳定组(SD)。比较两组ADC值增长率和肿瘤最大径,分析化学药物治疗1周期后ADC值变化率的受试者工作特征曲线(ROC)。结果两组ADC值于化学药物治疗后升高,PR组化学药物治疗第1周期后ADC值变化率高于SD组,差异有统计学意义(P=0.000);肿瘤最大径变化不明显;PR组化疗第1周期后ADC值变化率ROC曲线显示,以ADC值升高15.82%作为诊断分界点,敏感性为100%,特异性为60%。结论化学药物治疗前后ADC值的变化率可以作为早期预测肺癌化学药物治疗疗效的敏感指标,能够早于肿瘤最长径的变化对非小细胞肺癌的化学药物治疗疗效的评估。Objective To explore the value of diffusion-weighted MR imaging(DWI)in the evaluation of chemotherapy for peripheral non-smallcelllungcarcinoma.Methods 28 patients pathologyically diagnosed as non-smallcelllungcarcinomas(NSCLC)and received the first chemotherapy were included.Conventional MR and DWI were performed one week before chemotherapy and after the end of the first chemotherapy cycle but 2~3 days before chemotherapy second cycles.The measurable lesions were classified as patial remission group(PR)and disease stabilization group(SD)according to the RECIST standard.The growth rate of ADC value and the maximum diameter of tumor were compared between the two groups,and the receiver operating characteristic curve(ROC)of the change rate of ADC value after one cycle of chemotherapy was analyzed.Results The ADC value of the two groups increased after chemotherapy.The change rate of ADC value in PR group was higher than that in SD group after the first cycle of chemotherapy(P=0.000),while,the maximum diameter of tumor did not change significantly.The ROC curve of the change rate of ADC in PR group after first cycles of chemotherapy showed the ADC value increased by 15.82%as the diagnostic cut-off point for differentiating the PR lesion from the SD lesion.The overall sensitivity and specificity were 100%,60%.Conclusion The change rate of ADC value before and after chemotherapy can be used as a sensitive index for early prediction of chemotherapy efficacy of lung cancer,and can be used to evaluate the chemotherapy efficacy of NSCLC earlier than the change of tumor longest diameter.

关 键 词：磁共振成像 弥散加权成像 非小细胞肺癌 

分 类 号：R734.2[医药卫生—肿瘤] R445.2[医药卫生—临床医学]