表观弥散系数评估TACE治疗结直肠癌肝转移短期效果  

Apparent diffusion coefficient for evaluating short-term efficacy of TACE for treating colorectal cancer liver metastases

作　　者：袁光鸥 宋春明 侯雪妍 艾琦[1] 翁文采[1] YUAN Guang’ou;SONG Chunming;HOU Xueyan;AI Qi;WENG Wencai(Department of Radiology,Xinhua Hospital Affiliated to Dalian University,Dalian 116021,China;Department of Radiology,Wuhan Pulmonary Hospital,Wuhan 430040,China)

机构地区：[1]大连大学附属新华医院放射科,辽宁大连116021 [2]武汉市肺科医院放射科,湖北武汉430040

出　　处：《中国介入影像与治疗学》2024年第3期129-133,共5页Chinese Journal of Interventional Imaging and Therapy

基　　金：北京医学奖励基金项目(YXJL-2022-0105-0148);白求恩公益基金会“恒学精进-医学研究”项目(bcf-tzb-2020-004)。

摘　　要：目的观察表观弥散系数(ADC)评估TACE治疗结直肠癌肝转移(CRLM)短期效果的价值。方法回顾性分析接受TACE治疗的28例CRLM患者共60个肝转移癌灶,参考实体瘤疗效评价标准,根据首次TACE后MRI将其分为反应组(n=38)及无反应组(n=22);对比组间TACE前、后弥散加权成像(DWI)所获ADC相关参数,包括TACE前(ADC_(pre))、首次TACE后(ADC_(post1))及再次TACE后(ADC_(post2))ADC,计算ADC变化值(ΔADC)及ΔADC百分比。测量靶病灶最大径,分析ΔADC_(post1)与靶病灶最大径变化值的相关性;绘制受试者工作特征(ROC)曲线,计算曲线下面积(AUC),观察ΔADC_(post1)评估TACE治疗CRLM短期疗效的效能。结果组间ADC_(pre)差异无统计学意义(P=0.484);首次TACE后,反应组ADC_(post1)、ΔADC_(post1)及ΔADC_(post1)百分比均高于无反应组(P均<0.05);再次TACE后,组间ADC_(post2)、ΔADC_(post2)及ΔADC_(post2)百分比差异均无统计学意义(P均>0.05)。首次TACE后靶病灶最大径变化值为(-0.48±0.93)cm,与ΔADC_(post1)呈负相关(rs=-0.347,P=0.007)。ΔADC_(post1)评估TACE治疗CRLM短期效果的AUC为0.717。结论ADC用于评估TACE治疗CRLM的短期效果的效能良好。Objective To observe the value of apparent diffusion coefficient(ADC)for evaluating short-term efficacy of TACE for treating colorectal cancer liver metastases(CRLM).Methods Data of 60 liver metastases in 28 CRLM patients who underwent TACE were retrospectively analyzed.Based on MRI after the first TACE,according to the response evaluation criteria of solid tumors,the liver metastases were divided into response group(n=38)and nonresponse group(n=22).ADC parameters obtained with diffusion weighted imaging(DWI)before and after TACE,including ADC before TACE(ADC_(pre)),after the first TACE(ADC_(post1))and after the second TACE(ADC_(post2))were compared between groups,while ADC change value(ΔADC)and the percentage ofΔADC were calculated.The maximum diameter of the target foci were measured,and the correlation betweenΔADC_(post1)and the change of the maximum diameter of target foci were analyzed.Receiver operating characteristic curve was drawn,the area under the curve(AUC)was calculated to observe the efficacy ofΔADC_(post1)for evaluating short-term efficacy of TACE for CRLM.Results No significant difference of ADC_(pre)was found between groups(P=0.484).After the first TACE,ADC_(post1),ΔADC_(post1)and percentage ofΔADC_(post1)in response group were all higher than those in non-response group(all P<0.05).After the second TACE,no significant difference of ADC_(post2),ΔADC_(post2)nor percentage ofΔADC_(post2)was found between groups(all P>0.05).The maximum diameter change of the target foci after the first TACE was(-0.48±0.93)cm,which was negatively correlated withΔADC_(post1)(rs=-0.347,P=0.007).AUC ofΔADC_(post1)for evaluating short-term efficacy of TACE for CRLM was 0.717.Conclusion ADC had good efficacy for evaluating short-term efficacy of TACE for treating CRLM.

关 键 词：结直肠肿瘤 肿瘤转移 弥散磁共振成像 化学栓塞 治疗性 治疗转归 

分 类 号：R735.7[医药卫生—肿瘤] R445.2[医药卫生—临床医学]