小儿腹部中高危神经母细胞瘤新辅助化疗CT测量评价方法比较  

Comparison of different CT measurement methods in efficacy evaluation of neoadjuvant chemotherapy for pediatric abdominal neuroblastoma with intermediate-high risk

作　　者：王浩入 陈欣[1] 李婷 丁浩 张黎[1] 何玲[1] WANG Hao-ru;CHEN Xin;LI Ting;DING Hao;ZHANG Li;HE Ling(Department of Radiology,Children's Hospital of Chongqing Medical University,National Clinical Research Center for Child Health and Disorders,Ministry of Education Key Laboratory of Child Development and Disorders,Chongqing Key Laboratory of Pediatrics,Chongqing 400014,China)

机构地区：[1]重庆医科大学附属儿童医院放射科,国家儿童健康与疾病临床医学研究中心,儿童发育疾病研究教育部重点实验室,儿科学重庆市重点实验室,重庆400014

出　　处：《中国临床医学影像杂志》2023年第2期113-117,共5页Journal of China Clinic Medical Imaging

基　　金：重庆市教育委员会科学技术研究项目(KJQN202000440);重庆市科卫联合医学科研项目(2020FYYX128);重庆市渝中区基础研究与前沿探索项目(20200155);重庆市卫生健康委医学(含中医药类)科研项目(2022WSJK026)。

摘　　要：目的:比较小儿腹部中高危神经母细胞瘤新辅助化疗CT测量评价方法。方法:回顾性选取我院接受新辅助化疗的49例腹部中高危神经母细胞瘤,男31例,女18例,年龄2~144月。基于CT图像测量肿瘤在新辅助化疗前后的一维、二维和三维指标,并基于椭圆形公式计算肿瘤体积。逐层勾画肿瘤三维感兴趣区并得到勾画体积。计算不同测量指标在肿瘤新辅助化疗前后的改变。以勾画体积为参考标准,分析不同测量指标的相关性及一致性。结果:化疗前后的不同测量指标均与勾画体积具有显著正相关性(P均<0.001)。化疗前计算体积与勾画体积具有统计学差异(P<0.05),而化疗后计算体积与勾画体积无统计学差异(P>0.05)。化疗前后的不同测量指标比值与勾画体积比值均具有显著正相关性(P均<0.001)。计算体积比值与勾画体积比值无统计学差异(P<0.05),而一维、二维及三维测量比值与勾画体积比值均具有统计学差异(P均<0.001)。结论:一维、二维及三维测量虽然与腹部神经母细胞瘤在新辅助化疗后的体积改变均具有显著的正相关性,但均低估了腹部神经母细胞瘤对新辅助化疗的治疗反应,而根据椭圆形公式计算得出的体积改变更有助于反映腹部神经母细胞瘤在新辅助化疗后的实际改变。Objective: To compare the different CT measurements for pediatric abdominal neuroblastoma with intermediatehigh risk groups who received neoadjuvant chemotherapy. Methods: Forty-nine patients(31 males, 18 females;aged 2 ~144 months) with neuroblastoma who received neoadjuvant chemotherapy in our hospital were retrospectively included. One-dimen-sional, two-dimensional and three-dimensional indexes of tumor before and after chemotherapy were measured based on CT images, and tumor volume was calculated based on the elliptic formula. The whole tumor regions of interest(ROI) were delin-eated layer by layer and then volumes of ROI were obtained. The changes of different measurements to neoadjuvant chemotherapy were calculated. The correlation and consistency of different measurements were analyzed with the volume of ROI as a reference standard. Results: The different measurements before and after chemotherapy were positively correlated with volume of ROI(all P<0.001). There were statistically significant differences between calculated and delineated tumor vol-umes before chemotherapy(P<0.05), but no statistically significant difference between calculated and delineated tumor volumes after chemotherapy(P>0.05). There was a positive correlation between the ratio of different measurements and delineated volume ratio(P<0.001). There was no significant difference between the calculated volume ratio and the delineated volume ratio( P<0.05), but there were significant differences between the one-dimensional, two-dimensional and three-dimensional ratio and the delineated volume ratio(P<0.001). Conclusion: One-dimensional, two-dimensional and three-dimensional measurements underestimate the response of abdominal neuroblastoma to neoadjuvant chemotherapy, despite significant correlations with tumor changes, while tumor volumes calculated by the elliptic formula are more helpful in reflecting the real changes of abdominal neuroblastoma to neoadjuvant chemotherapy.

关 键 词：神经母细胞瘤 腹部肿瘤 儿童 体层摄影术 螺旋计算机 

分 类 号：R735.5[医药卫生—肿瘤] R339.31[医药卫生—临床医学] R814.42