不同b值ADC图评价宫颈癌放化疗早期疗效研究

Evaluation of Early Chemoradiotherapy Efficacy in Uterine Cervical Cancer by Different b-value ADC Images

目的探讨不同b值ADC图对宫颈癌放化疗早期疗效价值。方法 40例IIbIVa期宫颈癌患者,于治疗前、外照射2-3周、3次后装及放化疗后,行常规MRI及DWI扫描。按随访结果将患者分为完全缓解组(24例)、部分有效组(16例),测肿瘤最大径、ADC值,根据ROC曲线评价不同b值ADC图价值。结果在外照射2-3周及3次后装后,两组肿瘤缩小比差异无统计学意义(P>0.05)。外照射2-3周后,b=0、200,0、400,0、600,0、800,0,1000s/mm^2的ROC下面积为0.844、0.833、0.948、0.950、0.958;灵敏度为66.7%、75%、83.3%、84.5%、91.7%,特异度均为100%;3次后装后,b=0、200,0、400,0、600,0、800,0,1000s/mm^2的ROC下面积为0.885、0.802、0.948、0.949、0.974;灵敏度为75%、75%、85%、83.3%、91.8%,特异度均为100%;结论评价宫颈癌早期放化疗疗效时,高b值(b=0、600,0、800,1000s/mm^2)较低b值(b=0、200,0、400s/mm^2)价值高。

Objective To observe the evaluation of early chemoradiothempy efficacy in uterine cervical cancer by the different b-value ADC images. Methods 40 patients with middle and advanced stage uterine cervical cancer in stage Ⅱb-Ⅳa were recruited and received 4 conventional MRI and DWI exams before treatment, after 2-3 weeks , 3 times after intracavitary irradiation treatment and after treatment.The patients were divided into complete remission（CR）group（24 cases）, partial remission（PR）group（16 cases）according to the changes in tumor size after 8 mouths of treatmeut. The tumor size and apparent diffusion coefficient（ADC）of uterine cervical cancer were measured at each examination among the 2 groups. According the receiver operating characteristic（ROC）curve, chemoradiotherapy efficacy and prognosis value of different b-value of ADC images in uterine cervical cancer were compared. Results There were no significant differences of the tumor shrinking rate after 2-3 weeks and 3 times after intracavitary irradiation treatment in the 2 groups（P〉0.05）. After 2-3 weeks treatment, at b=0,200, 0,400, 0,600, 0,800 0,1000 s/mm^2 ADC images, ROC area trader curve was 0.844, 0.833, 0.048, 0.950, 0.958, sensitivity Was 66.7%, 75%, 83.3%, 84.5%, 91.7%, specificity was 100%, in 3 times after intracavitary irradiation treatment, at b=0,200, 0,400, 0,600, 0,800, 0,1000 s/mm^2 ADC images, ROC area under curve was 0.885, 0.802, 0.948, 0.949, 0.974, sensitivity Was75%, 75%, 85%, 83.3%, 91.8%, specificity was 100%. Conclusion When evaluating the early chemoradiothempy effect of cervical cancer, High value（b=0, 600, 0,800, 1000 s/mm^2） are better than lower b value（b=0,200, 0,400 s/mm^2）.