磁共振DWI及ADC值在恶性肿瘤治疗疗效评估中的临床应用研究

Study on the clinical application of DWI and ADC values of magnetic resonance in therapeutic evaluation of malignant tumor

目的研究磁共振功能成像DWI(扩散加权成像)及表观扩散系数(ADC)值在恶性肿瘤经非手术治疗(放射治疗、化疗、介入治疗等)前后或以上治疗过程中的数值变化,来评估该治疗效果的应用价值。方法收集2020年1月—2022年2月本院收治的100例恶性肿瘤患者治疗后的103个病灶,且所有患者在治疗前后或治疗期间行常规MRI扫描及DWI序列扫描,分析DWI成像序列显示肿瘤的信号特点,测量并记录瘤灶的病灶最大径及ADC值。分析肿瘤大小变化与ADC值变化之间的关系。结果恶性肿瘤肿瘤最大径缩小或失去活性(或部分失去活性),ADC值升高;肿瘤治疗复查过程中最大径无明显变化、病变基本稳定或肿瘤治疗无效复发、增大,ADC值无明显变化;肿瘤治疗中最大径增大或肿瘤前期有效而缩小或失活后,后期再次复发或进展,ADC值减低。结论磁共振表观扩散系数值ADC值可以对瘤灶进行定量测量,有效反应瘤灶的治疗后效果,可对恶性肿瘤治疗疗效起到较好的评价作用,从而为临床上进一步治疗提供可靠的依据。

Objective To study the numerical changes of DWI(diffusion-weighted imaging)and apparent diffusion coefficient(ADC)values of functional magnetic resonance imaging before and after non-surgical treatment of malignant tumors(radiotherapy,chemotherapy,interventional therapy,etc.)or during the above mentioned period,to evaluate the application value of the treatment effect.Methods 103 lesions of 100 patients with malignant tumors those were admitted to our hospital from January 2020 to February 2022 were collected after treatment,and all patients underwent conventional MRI scans and DWI sequence scans before and after treatment or during the treatment period.The signal characteristics of tumors shown by DWI imaging sequences was analyzed.The maximum diameter of the tumor and the ADC value were recorded.The relationship between changes in tumor size and changes in ADC values was analyzed.Results The maximum diameter of the malignant tumor decreased or lost its activity(or partially lost its activity),and the ADC value increased.During the review process of tumor treatment,the maximum diameter did not change significantly,the lesions were basically stable or the tumor recurred or increased for ineffective treatment,and the ADC value did not change significantly.The ADC value decreases,if the largest diameter increases during the treatment or the tumor recurred or advanced after shrink in early period of effective treatment or inactivation.Conclusions The ADC value of MR apparent diffusion coefficient value could quantitatively measure tumor lesion,effectively reflect the post-treatment effect of tumor foci,and could play a good role in evaluating the therapeutic effect on malignant tumor,thus providing a reliable basis for further clinical treatment.