3.0T MR弥散加权成像对食管癌放化疗的疗效评价

An investigation on evaluating the radio-chemotherapy effect on esophageal cancer using 3 T diffusion weighted MRI

目的利用3.0TMR弥散加权成像评价食管鳞状细胞癌放化疗的疗效。方法对18例食管鳞状细胞癌患者采用放疗行同步化疗,并于放化疗前及放化疗第1、3、5、10周行常规MRI平扫及DWI检查,测量并观察食管癌灶ADC值的变化。疗效根据RECIST标准评价。结果 18例食管鳞状细胞癌患者,除4例失访外,14例中完全缓解2例(14.3﹪),部分缓解9例(64.3﹪),病变稳定3例(21.4﹪),病变进展0例(0﹪)。除2例完全缓解患者因病灶消失无法测量ADC值外,12例治疗前,在b值分别取600、800和1000s/mm2时,食管癌灶ADC值分别是(1.62±0.23)×10-3mm2/s、(1.42±0.25)×10-3mm2/s、(1.21±0.27)×10-3mm2/s,同步放化疗后第10周ADC值分别是(2.77±0.46)×10-3mm2/s、(2.61±0.48)×10-3mm2/s、(2.37±0.49)×10-3mm2/s,ADC值较治疗前明显升高,差异均有统计学意义(P=0.000)。结论 3.0TMR弥散加权成像对食管鳞状细胞癌放化疗的疗效评价具有一定价值。

Objective To evaluation of radio-chemotherapy investigate the feasibility of using effect on esophageal squamous cell 3.0 T diffusion-weighted MRI for the carcinoma. Methods 18 patients with esophageal squamous cell carcinoma were recruited for the study. Concurrent radio chemotherapy was carried out on these patients. Routine MR/scan and DWI were performed on these patients before treatment as well as 1, 3, 5, and 10 weeks after the treatment. To measure and observe the changes of ADC values in esophageal carcinoma. The effect of the therapy was evaluated according to the RECIST standard. Results Among 18 patients, there are 4 who were unable to follow up. In the rest 14 patients, there are 2 with complete response （ 14.3 % ）, 9 with partial response （64.3 % ）, 3 with stable disease （21.4%）, and 0 with lesions in progress （0%）. Except that 2 patients with complete response ADC measurement was no longer applicable, in 12 patients when b = 600, 800 and 1000 s/mm^2, ADC values were （1.62 ± 0.23）×10^-3mm^2/s, （1.42 ± 0.25）×10^-3mm^2/s, （1.21 ±0.27）×10^-3mm^2/s respectively before treatment, and（2.77 ± 0.46）×10^-3mm^2/s, （2.61 ± 0.48）×10^-3mm^2/s and （2.37 ± 0.49）×10^-3mm^2/s after tenth week of the therapy. The difference was statistically significant （P = 0.000）. Conclusion 3.0 T MR diffusion-weighted imaging in esophageal cancer could help evaluate the curative effects of concurrent radio chemotherapy.