DCE-MRI定量参数评估肺癌BACE治疗早期疗效的初步研究  

Quantitative parameters of DCE-MRI to evaluate the early efficacy of BACE in lung cancer

作　　者：焦学莹 许祖闪 崔林阳 张学喜 JIAO Xueying;XU Zushan;CUI Linyang;ZHANG Xuexi(Department of Medical Imaging,Weifang Medical University,Weifang 261000,P.R.China;Department of Radiology,Weihai Central Hospital,Weihai 264400,P.R.China;GE Healthcare,China,Shanghai,200000,P.R.China)

机构地区：[1]潍坊医学院医学影像学系,山东潍坊261000 [2]山东省威海市中心医院影像科,山东威海264400 [3]GE Healthcare China,上海200000

出　　处：《医学影像学杂志》2019年第3期398-402,共5页Journal of Medical Imaging

摘　　要：目的探讨动态增强磁共振成像(DCE-MRI)定量参数对肺癌支气管动脉灌注化疗栓塞术(BACE)早期疗效的评估价值。方法收集经病理证实的18例肺癌患者,分别于术前一天和术后1个月行DCE-MRI检查。利用后处理软件分析图像,记录术前术后K^(trans)、K_(ep)、V_e、V_p四个定量参数的变化情况,比较术前术后各参数的差异。结果 1个月后复查,11例患者治疗有效,K^(trans)、K_(ep)、V_e、V_p四个数值较术前均下降,其中K^(trans)、K_(ep)、V_e的变化有统计学意义(P<0.05),V_p的下降无统计学意义(P>0.05),有效组与无效组术后四个数值相比,K^(trans)和V_p的差异有统计学意义(P<0.05),相应的AUC(曲线下面积)为1和0.818、灵敏度100%和85.7%,特异度100%和72.7%。结论 DCE-MRI定量参数有助于判断肺癌BACE治疗效果,但需要大样本、长期随访进一步研究。Objective To investigate the changes in quantitative parameters of dynamic contrast-enhanced magnetic resonance imaging(DCE-MRI) before and after the treatment of bronchi artery perfusion chemotherapy embolism(BACE) in lung cancer. Methods 18 patients who had been confirmed by pathological examination were collected, DCE-MRI was performed one day before and one month after surgery. MR images were analyzed through post-processing software to obtain four quantitative parameters, including Ktrans(volume transfer constant), Kep(the constant between tissue clearance and plasma), Ve(extracellular clearance volume fraction) and Vp(plasma volume fraction). The significant difference of pharmacokinetic parameters was detected to evaluate the BACE surgical. Results One month after the treatment, 11 patients were regarded as responders and had a significant decrease in Ktrans, Kep, and Ve(P < 0.05) while the downward trend in Vp had no statistical significance(P>0.05). The differences in Ktrans and Vp were also proven meaningful when compared responders with non-responders after treatment(P<0.05), the corresponding AUC(area under the curve), sensitivity, specificity were 1, 100%, 100% and 0.818, 85.7%, 72.7%, respectively. Conclusion Quantitative parameters of dynamic contrast-enhanced magnetic resonance imaging may contribute to determine the efficacy of bronchi artery perfusion chemotherapy embolism for lung cancer though large samples and long-term follow-up studies are needed.

关 键 词：肺癌 支气管动脉灌注化疗栓塞 磁共振成像 疗效 

分 类 号：R445.2[医药卫生—影像医学与核医学] R734.2[医药卫生—诊断学]