论文部分内容阅读
目的探讨磁共振弥散加权成像(DWI)早期评估食管癌同期放化疗疗效的临床价值。方法回顾性分析2013年5月至2014年12月南通市肿瘤医院收治的食管癌患者35例,所有患者入院时进行常规检查以及胃镜、病理、CT及食管钡片等检查,给予脑MRI或骨扫描排除远处转移。所有患者采用同期放化疗的治疗方案,在治疗前、治疗中第3周末,治疗结束后行常规MRI扫描,对DWI图像进行后处理合成ADC图。结果伴随b值增加,ADC值逐渐降低(P<0.01)。b值为600 s/mm2时的图像最为清晰,随治疗时间的延长,缓解组与未缓解组的ADC值也相应增加(P<0.01);缓解组与未缓解组在治疗前、治疗3周末的ADC值比较差异有统计学意义(P均<0.05)。随治疗时间的延长,缓解组与未缓解组的食管癌病变长度也相应缩短;治疗前,缓解组与未缓解组的食管癌病变长度比较无统计学差异(P>0.05);未缓解组各时间点的食管癌病变长度比较无统计学差异(P>0.05);缓解组治疗3周末和治疗结束时的食管癌病变长度明显短于未缓解组,差异有统计学意义(P均<0.01)。经Logistic多元回归分析显示,当b值为600 s/mm2时,肿瘤病变治疗前ADC值与治疗结束时肿瘤病变长度呈负相关(r=-0.710,P=0.000)。结论 DWI通过对食管癌患者治疗前后ADC值及病变长度变化来对食管癌早期放化疗疗效进行准确评估。但由于本组研究样本量选择较少,研究时间较短,所用的MRI设备有些滞后,存在一些不足之处,今后要加大样本量并延长研究时间进行更深入的探讨。
Objective To investigate the clinical value of early diffusion weighted imaging (DWI) in evaluating the efficacy of concurrent chemoradiotherapy in esophageal cancer. Methods A retrospective analysis of 35 patients with esophageal cancer admitted to Nantong Cancer Hospital from May 2013 to December 2014 was conducted. All patients underwent routine examination and gastroscopy, pathology, CT and esophageal barium examination. All patients underwent MRI or bone MRI Scan to exclude distant metastasis. All patients were treated with concurrent chemoradiotherapy. Before the treatment and at the end of the third week of treatment, conventional MRI scans were performed after the treatment. The DWI images were post-processed to synthesize ADC maps. Results With the increase of b value, the ADC value decreased gradually (P <0.01). When the b value was 600 s / mm2, the image was the most clear. With the prolongation of treatment time, the ADC value of remission group and non-remission group also increased accordingly (P <0.01); before remission and remission group, The difference of ADC value was statistically significant (all P <0.05). With the extension of treatment time, the length of esophageal cancer in remission group and non-remission group also shortened correspondingly. Before treatment, there was no significant difference in the length of esophageal cancer between remission group and non-remission group (P> 0.05) (P> 0.05). The length of esophageal cancer lesions in the remission group at the end of 3 weeks and at the end of treatment was significantly shorter than that in the non-remission group, with significant difference (P <0.01) . Logistic multivariate regression analysis showed that when the b value was 600 s / mm2, the ADC value of tumor lesions before treatment was negatively correlated with the length of tumor lesions at the end of treatment (r = -0.710, P = 0.000). Conclusions DWI can accurately assess the effect of early chemoradiotherapy on esophageal cancer through the changes of ADC value and lesion length before and after the treatment of esophageal cancer patients. However, due to the small sample size, short research time, and the lagged MRI equipment used in this study, there are some shortcomings. In the future, we should increase the sample size and extend the study time to conduct a more in-depth discussion.