IVIM-DWI定量分析对扶正消瘀散结方联合内分泌治疗Ⅲ、Ⅳ期前列腺癌疗效的评估研究  

Quantitative Diagnostic Value of IVIM-MRI to Evaluate the Efficacy in Fuzheng Xiaoyu Sanjie Combined with Endocrine Treatment for Ⅲ、Ⅳ Stage-Prostate Cancer

作　　者：徐嬿[1] 杨贤卫[1] 王千里 康尚煜 蔡德春[1] XU Yan;YANG Xianwei;WANG Qianli(Department of Radiology,The First Affiliated Hospital of Guangzhou University of Chinese Medicine,Guangzhou,Guangdong Province 510405,China)

机构地区：[1]广州中医药大学第一附属医院影像科,510405

出　　处：《临床放射学杂志》2022年第10期1926-1930,共5页Journal of Clinical Radiology

基　　金：广东省中医药局科研项目(编号:20202051)。

摘　　要：目的 探讨3.0TMRI体素内不相干运动(IVIM)评价扶正消瘀散结方联合内分泌治疗Ⅲ、Ⅳ期前列腺癌的疗效,从微观角度证实和评价中医药的疗效,探讨可能的作用机制.方法 搜集2020年1月至今本院前列腺癌Ⅲ、Ⅳ期的患者60例,分为实验组30例,采用扶正消瘀散结方联合内分泌治疗,对照组30例,采用单纯内分泌治疗;采用IVIM-DWI获取前列腺癌组织的真实扩散系数(D)、伪扩散系数(D*)、灌注分数(f),分别对两组治疗前、治疗3个月后的各项指标(D值、D*值、f值)进行配对样本t检验,随后用两独立样本t检验进一步分析比较两组治疗前后各指标的差异.结果 两组患者治疗前的前列腺癌组织的D值、D*值、f值无统计学差异(P>0.05).两组患者治疗前后对比,前列腺癌组织的D值有统计学差异(P<0.05),D值治疗后数值高于治疗前,D*值、f值无统计差异(P>0.05).治疗3个月后实验组与对照组前列腺癌组织的D值有统计学差异(P<0.05),且实验组D值数值高于对照组,D*值、f值无统计差异(P>0.05).结论 两种治疗方法对晚期前列腺癌患者均有一定效果,IVIM-DWI定量参数中D值是评价前列腺癌治疗疗效的重要参考指标,并且扶正消瘀散结方联合内分泌治疗的疗效高于单纯内分泌治疗.Objective To investigate the efficacy of 3.0 T magnetic resonance intravoxel incoherent motion diffusion weighted imaging(IVIM-MRI)quantitative analysis in evaluation of Fuzheng Xiaoyu Sanjie combined with endocrine treatment forⅢandⅣstage-prostate cancer.To confirm and evaluate the efficacy of Chinese medicine from a microscopic perspective and to explore the possible mechanism.Methods Sixty patients with prostate cancer of stageⅢandⅣin our hospital from January 2020 to the present were collected,and divided into 30 cases in the experimental group,who were treated with the combination of endocrine therapy with Fuzheng Xiaoyu Sanjie,and 30 cases in the control group,who were treated just with endocrine therapy;the quantitative parameter values of microcirculatory perfusion in prostate cancer tissues were obtained by intravoxel incoherent motion MRI,including D、D*and f Value.The quantitative parameters(D、D*and f)were tested by paired samples t-test before and after 3 months of treatment in the two groups,followed by two independent samples t-test to further analysis and to compare the differences between the two groups before and after treatment.Results The quantitative parameter of D、D*and f Value in two groups showed no significant difference before treatment between two groups(P>0.05).The values of D Value in all patients were significantly different after 3 months therapy(P<0.05),D value raised after the therapy,and D*and f Value showed no significant difference after 3 months therapy(P>0.05).D value in the experimental group was significantly higher than that in the control group(P<0.05),and D*and f values in the experimental group showed no significant difference between the two groups(P>0.05).Conclusion Both treatments were effective in patients with advanced prostate cancer,D value by IVIM-MRI is an important reference index for evaluating the therapeutic effect of prostate cancer,and Fuzheng Xiaoyu Sanjie combinaed with endocrine therapy was more efficient than that of endocrine therapy alon

关 键 词：前列腺癌 扶正消瘀散结 扩散加权成像 体素内不相干运动 

分 类 号：R737.25[医药卫生—肿瘤] R445.2[医药卫生—临床医学]