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| 表观扩散系数值在直肠癌术前放化疗疗效评价中的应用价值 |
| ADC value in preoperative radiochemotherapy for rectal carcinoma |
| 投稿时间：2015-01-28 修订日期：2015-03-20 |
| DOI：10.3969/j.issn.1000-0399.2015.05.017 |
| 中文关键词: 直肠肿瘤 磁共振成像 放化疗 表观扩散系数 |
| 英文关键词: Rectal neoplasm Magnetic resonance imaging Diffusion-weighted Radiochemotherapy Apparent diffusion coefficient |
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| 中文摘要: |
| 目的 探讨表现扩散系数(ADC)值在评估直肠癌术前同步放化疗疗效的可行性及应用价值。方法 20例术前同步放化疗的直肠癌患者,在放化疗前、放疗至10 Gy、放疗至20 Gy及手术前4个监测时间点行磁共振检查,测量ADC值,并测量病灶长度和厚度。将患者放化疗前的临床分期及术后分期比较分为T-降期组和T-未降期组,应用方差分析及独立样本t检验比较肿瘤ADC值、长度及厚度的变化情况。结果 两组平均ADC值在放疗前及放疗至20 Gy时差异有统计学意义(P<0.05),其中T-降期组在放疗至20 Gy时平均ADC值较治疗前明显升高,差异有统计学意义(P<0.05)。两组病灶平均长度及厚度在各监测时间点差异均无统计学意义(P>0.05),但两组病灶放化疗前的平均长度及厚度与手术前比较明显减少,差异有统计学意义(P<0.05)。结论 术前放化疗对直肠癌的治疗有效。ADC值在早期评价直肠癌术前同步放化疗的疗效方面具有一定的价值。 |
| 英文摘要: |
| Objective To monitor early treatment response using apparent diffasion coefficient (ADC) value to predict response of rectal carcinoma by preoperative radiochemotherapy. Methods Twenty patients with rectal carcinoma were treated with preoperative radiochemotherapy, followed by surgery. Diffusion-weighted imaging MRI(DWI) was performed in all patients at four-time points (prior to radiochemotherapy, dose to 10 Gy, 20 Gy and before surgery) and classified to T-downstaging group and T-no-downstaging group. Variance and independent sample t test were analysed to compare the changes of tumor ADC values, length and thickness between the groups. Results A statistical significant correlation was found between T-downstaging group and T-no-downstaging group in preoperative ADC value (P<0.05). In T-downstaging group, the mean ADC value increased significantly compared to the mean ADC value prior to radiochemotherapy at the time point of dose to 20 Gy (P<0.05). Before surgery, in T-downstaging group and T-no-downstaging group, the mean length and thickness decreased significantly compared to the mean length and thickness prior to radiochemotherapy (P<0.05). Conclusion Preoperative radiochemotherapy is effective in the treatment of rectal cancer. ADC value in rectal carcinoma is a valuable clinical tool to help assess the therapeutic effect of radiochemotherapy at an early time point. |
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