摘要
目的探讨体素内不相干运动(IVIM)-MRI在宫颈癌根治性同步放化疗效果评价中的应用价值。方法收集2019年2月至2021年6月华北理工大学附属医院诊治的中晚期宫颈癌患者67例,所有受试者均接受同步放化疗,在治疗前3 d内(治疗前)、治疗3周(治疗中)及治疗结束后3 d(治疗后)行常规MRI、弥散加权成像(DWI)及IVIM扫描。将治疗后肿瘤体积比治疗前减少1/3以上的患者纳入治疗敏感组,其余为治疗非敏感组。计算肿瘤消退率;比较两组不同时间点影像参数、参数变化率;分析影像参数与肿瘤消退率的相关性。结果治疗前,治疗敏感组表观弥散系数(ADC)值、扩散系数(D)值、假扩散系数(D*)值高于治疗非敏感组(P<0.05);治疗中,治疗敏感组ADC值、D值、D值、灌注分数(f)值高于治疗非敏感组(P<0.05);治疗后,治疗敏感组ADC值、D值、f值高于治疗非敏感组(P<0.05)。治疗中及治疗后,治疗敏感组ADC值、D值、f值变化率高于治疗非敏感组(P<0.05)。67例患者肿瘤消退率为(66.3±24.8)%。治疗前,ADC值、f值与肿瘤消退率呈正相关(r>0,P<0.05);治疗中,ADC值、D值变化率与肿瘤消退率呈正相关(r>0,P<0.05);治疗后,ADC值、D值变化率与肿瘤消退率呈正相关(r>0,P<0.05)。结论IVIM参数及其变化率对评估中晚期宫颈癌根治性同步放化疗效果有一定的指导性意义。
Objective To investigate the application value of introvoxel incoherent motion(IVIM)-MRI in evaluation of curative effect of radical concurrent chemoradiotherapy for cervical cancer.Methods A total of 67 patients with middle and advanced cervical cancer diagnosed and treated in the Affiliated Hospital of North China University of Science and Technology from February 2019 to June 2021 were collected,all subjects received concurrent chemoradiotherapy.Routine MRI,diffusion weighted imaging(DWI)and IVIM were performed within three days before treatment(before treatment),treatment for three weeks(in the treatment),and three days after treatment(after treatment).Patients whose tumor volume decreased by more than 1/3 after treatment compared with before treatment were included in the treatment sensitive group,and the rest were treatment non-sensitive group.The tumor regression rate was calculated;image parameters and parameter change rate at different time points were compared between two groups;the correlation between imaging parameters and tumor regression rate was analyzed.Results Before treatment,the apparent diffusion coefficient(ADC)value,diffusion coefficient(D)value and false diffusion coefficient(D)value of treatment sensitive group were higher than those of treatment non-sensitive group(P<0.05);in the treatment,ADC value,D value,D*value,and perfusion score(f)value in treatment sensitive group were higher than those in treatment non-sensitive group(P<0.05);after treatment,ADC value,D value,and f value in treatment sensitive group were higher than those in treatment non-sensitive group(P<0.05).In the treatment and after treatment,the change rate of ADC value,D value,and f value in treatment sensitive group was higher than those in treatment non-sensitive group(P<0.05).The tumor regression rate of 67 patients was(66.3±24.8)%.Before treatment,ADC value and f value were positively correlated with tumor regression rate(r>0,P<0.05);in the treatment,the change rate of ADC value and D value were positively correlated with tumor regression rate(r>0,P<0.05);after treatment,the change rate of ADC value and D value were positively correlated with tumor regression rate(r>0,P<0.05).Conclusion IVIM parameters and their change rate have certain guiding significance for evaluating the effect of radical concurrent chemoradiotherapy for middle and advanced cervical cancer.
作者
李伟兰
谢宗源
王雅静
李晖
陈伟彬
王志强
张惠英
LI Weilan;XIE Zongyuan;WANG Yajing;LI Hui;CHEN Weibin;WANG Zhiqiang;ZHANG Huiying(Department of Medical Imaging,Affiliated Hospital of North China University of Science and Technology,Hebei Province,Tangshan063000,China)
出处
《中国医药导报》
CAS
2022年第19期160-163,共4页
China Medical Herald
基金
河北省医学科学研究课题(20201245)。
关键词
中晚期宫颈癌
磁共振成像
体素内不相干运动
同步放化疗
疗效评价
Middle and advanced cervical cancer
Magnetic resonance imaging
Introvoxel incoherent motion
Concurrent chemoradiotherapy
Efficacy evaluation
