磁共振DWI技术对贝伐珠单抗联合放射治疗脑胶质瘤术后进展的预测价值  

Predictive Value of Magnetic Resonance DWI Technique for Postoperative Progression of Glioma Patients Treated with Bevacizumab Combined with Radiotherapy

作　　者：何晨曦 王伟[1] 冯会玉 孟凡然 孟少林 徐伟[1] 高飞[1] HE Chen-xi;WANG Wei;FENG Hui-yu;MENG Fan-ran;MENG Shao-lin;XU Wei;GAO Fei(Medical Imaging Department of Zhuozhou Hospital,Zhuozhou 072750,Hebei Province,China;Radiotherapy Department of Hebei Yizhou Cancer Hospital,Zhuozhou 072750,Hebei Province,China)

机构地区：[1]河北省涿州市医院医学影像科,河北涿州072750 [2]河北一洲肿瘤医院放疗科,河北涿州072759

出　　处：《中国CT和MRI杂志》2023年第6期11-13,共3页Chinese Journal of CT and MRI

基　　金：保定市科技计划项目(2041ZF346)。

摘　　要：目的探讨磁共振弥散加权成像(DWI)技术对贝伐珠单抗联合放射治疗脑胶质瘤(BG)术后进展的预测价值。方法选取2018年4月至2020年4月我院BG患者86例进行回顾性研究。术后1 d行瘤周水肿区(瘤腔周缘以外≤1 cm之内的区域)DWI检查,比较不同临床资料患者ADC_(mean)、rADC_(mean)、ADC_(min)、ADC_(max)值,统计术后1年无进展生存率,分进展组与未进展组,比较两组ADC_(mean)、rADC_(mean)、ADC_(min)、ADC_(max)值,分析ADC_(mean)、rADC_(mean)、ADC_(min)、ADC_(max)值与BG术后无进展生存的相关性,受试者工作特征(ROC)曲线分析ADC_(mean)、rADC_(mean)、ADC_(min)、ADC_(max)值对术后无进展生存的预测价值,对比进展组中Ⅳ级、Ⅲ级BG患者ADC_(mean)、rADC_(mean)、ADC_(min)、ADC_(max)值。结果Ⅳ级BG患者ADC_(mean)、rADC_(mean)、ADC_(min)、ADC_(max)值低于Ⅲ级BG患者(P<0.05);有浸润的BG患者ADC_(mean)、rADC_(mean)、ADC_(min)、ADC_(max)值低于无浸润的BG患者(P<0.05);进展组ADC_(mean)、rADC_(mean)、ADC_(min)、ADC_(max)值均低于未进展组(P<0.05);Logistic回归分析显示,ADC_(mean)、rADC_(mean)、ADC_(min)、ADC_(max)值均与无进展生存相关(P<0.05);ADC_(mean)、rADC_(mean)、ADC_(min)、ADC_(max)值联合预测无进展生存的AUC值最大0.857,对应敏感度为92.86%,特异度为70.69%;进展组中Ⅳ级、Ⅲ级BG患者ADC_(mean)、rADC_(mean)、ADC_(min)、ADC_(max)值比较,差异无统计学意义(P>0.05)。结论BG术后瘤周水肿区ADC_(mean)、rADC_(mean)、ADC_(min)、ADC_(max)值与贝伐珠单抗联合放射治疗BG术后无进展生存有关,可作为预测患者术后无进展生存的指标。Objective To investigate the predictive value of magnetic resonance diffusion-weighted imaging(DWI)technology in the postoperative progression of bevacizumab combined with radiation therapy for brain glioma(BG).Methods A retrospective study of 86 BG patients in our hospital from April 2018 to April 2020 were selected.DWI was performed on the peritumoral edema area(area outside the periphery of the tumor cavity within≤1 cm)at 1 d after the operation.The ADC_(mean),rADC_(mean),ADC_(min),and ADC_(max)values of patients with different clinical data were compared.According to the progression at 1 year after operation,they were divided into progression group and non-progression group.The ADC_(mean),rADC_(mean),ADC_(min),and ADC_(max)values of the two groups were compared.The correlation between ADC_(mean),rADC_(mean),ADC_(min),ADC_(max)values and progression after BG were analyzed.The predictive value of ADC_(mean),rADC_(mean),ADC_(min),and ADC_(max)to predict postoperative progression were analyzed through receiver operating characteristic(ROC)curve.The ADC_(mean),rADC_(mean),ADC_(min),ADC_(max)values ofⅣ级andⅢ级BG patients in the progression group were compared.Results ADC_(mean),rADC_(mean),ADC_(min)and ADC_(max)values ofⅣ级BG patients were lower than those ofⅢ级BG patients(P<0.05);ADC_(mean),rADC_(mean),ADC_(min)and ADC_(max)values of the progression group were lower than those of the nonprogression group(P<0.05);Logistic regression analysis showed that ADC_(mean),rADC_(mean),ADC_(min),ADC_(max)values were all related to progression(P<0.05);The combination of ADC_(mean),rADC_(mean),ADC_(min),and ADC_(max)values had a_(max)imum AUC value of 0.857 for predicting progression,with a corresponding sensitivity of 92.86%and a specificity of 70.69%;There was no statistically difference of the ADC_(mean),rADC_(mean),ADC_(min),and ADC_(max)values ofⅣ级andⅢ级BG patients in the progression group(P>0.05).Conclusions ADC_(mean),rADC_(mean),ADC_(min),ADC_(max)values of peritumoral edema after BG are related to

关 键 词：磁共振 弥散加权成像 表观扩散系数 脑胶质 

分 类 号：R445.2[医药卫生—影像医学与核医学]