磁共振弥散信号强度对结肠腺癌肝脏转移的化疗早期疗效评价的价值

The Value of 3.0T-MR DWI to Early Evaluate the Chemotherapy Response of Liver Metastases from Colonic Adenocarcinoma

目的研究3.0T磁共振弥散加权成像(DWI)病灶信号强度预测和早期监测结肠癌肝脏转移瘤化疗疗效的可行性。方法收集27例结肠腺癌肝脏转移瘤行化疗的患者,分析信号强度定量指标(信号噪声比SNR、对比噪声比CNR)评价肝转移瘤化疗早期疗效的可行性及效能。结果化疗前,临床评价有效组病灶CNR高于无效组,差异有统计学意义;利用ROC曲线分析,选取转移瘤化疗前CNR值45.6为阈值,其灵敏度及特异度分别为89%、53%,曲线下面积为0.71。临床评价有效组治疗后SNR及CNR均较治疗前降低,差异有统计学意义。结论DWI信号强度定量分析,可用于结肠腺癌肝脏转移瘤化疗疗效的早期评价。

Objective To evaluate the feasibility of 3.0T diffusion-weighted imaging(DWI)in early predicting and monitoring the efficacy of chemotherapy to the liver metastases from colon cancer.Methods 27 colonic adenocarcinoma patients with liver metastases undergoing chemotherapy were collected.Quantitative indicators(including signal-to-noise ratio[SNR]and contrast-to-noise ratio[CNR])of liver metastases on DWI were analyzed,to assess the accuracy of above indicators in early predicting therapeutic response.Results According to the RECIST criteria,all 27 patients were divided into two groups:responder and nonresponder.Before the chemotherapy,at the b value of 600s/mm2,the CNR of the responder group was higher than that of nonresponder group,and the difference was statistically significant.When the threshold value of CNR before chemotherapy was 45.6 by ROC curve analysis,the sensitivity and specificity were 89%and 53%respectively,with the area under the curve of 0.71.In the responder group,the SNR and CNR of the metastatic lesions reduced after treatment compared with pre-chemotherapy,and the difference was statistically significant.Conclusion Quantitative signal intensity index on DWI can be used for early evaluating the therapeutic response of liver metastases in colon cancer patients.