CT血管造影联合表观弥散系数全域直方图评估宫颈癌新辅助化疗效果的价值分析

Assessment value of CT angiography combined with the global histogram of apparent diffusion coefficient on the effect of neoadjuvant chemotherapy for cervical cancer

目的:分析CT血管造影(CTA)联合表观弥散系数(ADC)全域直方图评估宫颈癌新辅助化疗效果的价值。方法:选取2021年7月至2022年10月喀什地区第一人民医院收治的40例术前新辅助化疗的宫颈癌患者,所有患者均在化疗前1 d和化疗结束后1 d行CTA、ADC全域直方图检查,比较CTA参数血容量(BV)、血流量(BF)、表面通透性(PS)以及平均通过时间(MTT),ADC全域直方图定量参数ADC值水平。结果:40例宫颈癌患者中新辅助化疗有效28例,无效12例。化疗后ADC值水平高于化疗前,BV、BF及PS水平低于化疗前,MTT水平高于化疗前,差异有统计学意义(t=9.558、8.283、7.852、7.302、18.480,P<0.05)。与新辅助化疗有效患者相比,新辅助化疗无效患者ADC值水平较低,BV、BF、PS水平较高,MTT水平较低(t=2.988、6.654、3.767、7.851、6.237,P<0.05)。受试者工作特征(ROC)曲线分析显示,两项联合预测宫颈癌新辅助化疗无效的ROC曲线下面积(AUC)高于CT血管造影、ADC全域直方图单项检测,AUC分别为0.905、0.839、0.729。结论:宫颈癌新辅助化疗后ADC值和MTT水平升高,BV、BF及PS水平降低,且化疗有效患者ADC值、MTT水平高于无效患者,BV、BF及PS水平低于无效患者,CTA联合ADC全域直方图对宫颈癌新辅助化疗无效的预测价值较高。

Objective:To analyze the assessment value of computed tomography(CT)angiography combined with global histogram of apparent diffusion coefficient(ADC)on the effect of neoadjuvant chemotherapy for cervical cancer.Methods:A total of 40 patients with cervical cancer who admitted to the First People's Hospital of Kashgar Region from July 2021 to October 2022 and underwent neoadjuvant chemotherapy before surgery were selected.All patients underwent CT angiography and ADC global histogram examination at 1 day before and after chemotherapy.The blood volume(BV),blood flow(BF),permeability surface(PS)and mean transit time(MTT)of CT angiography parameters,and the ADC value of the quantitative parameter of ADC global histogram were compared.Results:In 40 patients with cervical cancer,neoadjuvant chemotherapy was effective for 28 cases,while it was invalid for 12 cases.ADC value after chemotherapy was higher than that before chemotherapy,and BV,BF and PS levels after chemotherapy were respectively lower than those before chemotherapy,and MTT level after chemotherapy was higher than that before chemotherapy,with statistical significances(t=9.558,8.283,7.852,7.302,18.480,P<0.05).Compared with the patients who were effective by using neoadjuvant chemotherapy,the patients who were ineffective by using neoadjuvant chemotherapy had lower ADC value,and higher BV,BF and PS levels,and lower MTT level,and the differences were significant(t=2.988,6.654,3.767,7.851,6.237,P<0.05),respectively.The analysis of receiver operating characteristic(ROC)curve showed that the area under curve(AUC)value of the combined prediction for the ineffectiveness of neoadjuvant chemotherapy for cervical cancer was respectively higher than that of the single CT angiography and that of ADC global histogram(AUC=0.905,0.839,0.729).Conclusion:After patients with cervical cancer receive neoadjuvant chemotherapy,ADC value and MTT level increase,while BV,BF and PS levels decrease.In addition,the ADC values and MTT levels in patients with effective chemotherapy were higher than those in patients without effective chemotherapy,while BV,BF and PS levels in former were lower than those in patients without effective chemotherapy.The CT angiography combined with ADC global histogram has higher predictive value for the ineffectiveness of neoadjuvant chemotherapy for cervical cancer.