简化和标准肝脏MRI方案在结直肠癌肝转移患者随访中的临床应用  

Clinical application cf simplified and standard liver MRI protocols in follow-up of patients with liver metastasesfromcolorectal cancer

作　　者：谢丽春 欧庆芬 张秋萍 叶升[2] Xie Lichun;Ou Qingfen;Zhang Qiuping;Ye Sheng(Department of Radiology Diagnosis,General Hospital of the Southern Theater Command of the Chinese People's Liberation Army,Guangzhou Guangdong Province 510040,China;Department of Oncology,First Affiliated Hospital of Sun Yat sen University,Guangzhou Guangdong Province 510100,China)

机构地区：[1]中国人民解放军南部战区总医院放射诊断科,广州510040 [2]中山大学附属第一医院肿瘤科,广州510100

出　　处：《中华普外科手术学杂志（电子版）》2024年第4期434-437,共4页Chinese Journal of Operative Procedures of General Surgery(Electronic Edition)

基　　金：科技部国家重点研发计划重点专项(2018YFC1313400)。

摘　　要：目的比较简化肝脏核磁共振成像(MRI)方案和标准肝脏MRI方案在评估疾病的存在、节段受累和对化疗的反应及手术计划方面对比,用于结直肠癌肝转移的治疗后随访。方法回顾性分析2020年1月至2023年1月连续接受化疗的113例结直肠癌肝转移患者的临床资料,化疗前和化疗后8~12周分别进行简化和标准肝脏MRI方案。治疗后获得的图像,根据RECIST1.1记录治疗反应。使用加权Cohenkappa统计量确定图像集之间的一致性水平,采用Friedman检验比较不同MRI评估疾病情况。P<0.05被认为差异有统计学意义。结果标准方案和简化方案的总转移数具有很高的一致性(组内相关系数=0.97)。各节段受累的加权k为0.73-0.85,各节段的加权kappa值为0.82。节段受累的差异并没有改变潜在的手术计划。使用简化方案与标准方案对RECIST1.1治疗反应进行分类显示出很好的一致性(加权K=0.92)。结论仑简化肝脏MRI方案允许在化疗后进行评估,类似于标准肝脏MRI方案。使用简化的方案可以减少成像时间,而不会牺牲对结直肠癌肝转移的后续诊断性能.Objective The simplified hepatic magnetic resonance imaging(MRI)protocol was compared with the standard hepatic MRI protocol in assessing the presence of disease,segmental involvement,and response to chemotherapy,as well as surgical planning,for post-treatment follow-up of colorectal metastases.Methods Clinical data of 113 patients with liver metastases from colorectal cancer who received continuous chemotherapy from January 2020 to January 2023 were retrospectively analyzed.Simplified and standard liver MRI regimens were performed before chemotherapy and 8 to 12 weeks after chemotherapy.For images obtained after treatment,treatment responses were recorded according to RECIST 1.1.Weighted Cohen kappa statistics were used to determine the consistency level between image sets,and Friedman test was used to compare the disease assessment of different MRI.P<0.05 was considered statistically significant.Results The total transfer numbers of the standard scheme and the simplified scheme were highly consistent(intra-group correlation coefficient=0.97).The weighted k of each segment was 0.73 to 0.85,and the weighted kappa of each segment was O.82.The difference in segmental involvement did not alter the underlying surgical plan.Classification of response to RECIST 1.1 using simplified versus standard regiments showed good agreement(weighted k=0.92).Conclusion The simplified liver MRI protocol allows evaluation after chemotherapy and is similar to the standard liver MRI protocol.Using a simplified protocol can reduce imaging time without sacrificing subsequent diagnostic performance for liver metastases in colorectal cancer.

关 键 词：结直肠肿瘤 肝转移 磁共振成像 疗效比较研究 

分 类 号：R735.34[医药卫生—肿瘤]