DCE-MRI联合DWI在局部晚期肺癌合并肺不张患者放疗中的应用  

Application of DCE-MRI Combined with DWI in Radiotherapy for Patients with Locally Advanced Lung Cancer Complicated with Atelectasis

作　　者：李冬梅 张世斌 周成星 俞根 LI Dongmei;ZHANG Shibin;ZHOU Chengxing;YU Gen(Pingxiang Ganxi Cancer Hospital,Jiangxi Province,Pingxiang 337000,China;不详)

机构地区：[1]江西省萍乡赣西肿瘤医院,江西萍乡337000

出　　处：《中国医学创新》2023年第27期40-44,共5页Medical Innovation of China

基　　金：江西省卫生健康委科技计划项目(20194268)。

摘　　要：目的:探讨动态对比增强磁共振成像(DCE-MRI)联合弥散加权成像(DWI)在局部晚期肺癌合并肺不张患者放疗中的应用价值。方法:本研究为前瞻性研究,纳入萍乡赣西肿瘤医院2020年6月—2022年6月收治的70例局部晚期肺癌合并肺不张患者,采用随机数字表法分为研究组(n=35)和对照组(n=35)。对照组基于DWI图像勾画放疗靶区,研究组基于DCE-MRI联合DWI图像勾画放疗靶区,所有患者均施行三维适形调强放疗。比较两组患者大体肿瘤体积(GTV)、近期疗效、肺复张情况、放射性并发症发生率。结果:放疗前,研究组GTV小于对照组(P<0.05)。两组客观缓解率(ORR)、疾病控制率(DCR)比较,差异均无统计学意义(P>0.05)。研究组肺复张率高于对照组,放射性食管炎发生率低于对照组(P<0.05)。结论:DCE-MRI联合DWI指导三维适形调强放疗能够提高放疗靶区勾画的精准度,提高局部晚期肺癌合并肺不张患者放疗后的肺复张率,减少放射性食管炎发生。Objective:To investigate the application value of dynamic contrast-enhanced magnetic resonance imaging(DCE-MRI)combined with diffusion weighted imaging(DWI)in radiotherapy for patients with locally advanced lung cancer complicated with atelectasis.Method:This was a prospective study.A total of 70 patients with locally advanced lung cancer complicated with atelectasis admitted to Pingxiang Ganxi Cancer Hospital from June 2020 to June 2022 were enrolled and divided into study group(n=35)and control group(n=35)according to random number table method.The control group mapped the radiotherapy target area based on DWI images,and the study group mapped the radiotherapy target area based on DCE-MRI combined with DWI images.All patients underwent three-dimen-sional conformal intensity-modulated radiation therapy.Gross tumor volume(GTV),shortterm effect,lung recruitment situation and incidence of radioactivity complications were compared between the two groups.Result:Before radiotherapy,GTV in the study group was smaller than that in the control group(P<0.05).There were no significant differences in objective response rate(ORR)and disease control rate(DCR)between the two groups(P>0.05).The lung recruitment rate in the study group was higher than that in the control group,and the incidence of radioactivity oesophagitis was lower than that in the control group(P<0.05).Conclusion:Threedimen-sional conformal intensity-modulated radiation therapy guided by DCE-MRI combined with DWI can improve the accuracy of radiotherapy target delineation,increase the lung recruitment rate after radiotherapy in patients with locally advanced lung cancer complicated with atelectasis,and reduce the incidence of radioactivity oesophagitis.

关 键 词：局部晚期 肺癌 肺不张 放疗 动态对比增强磁共振成像 弥散加权成像 

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