【摘要】 目的探讨磁共振弥散加权成像(DWI)及CT灌注技术(CTP)对非小细胞肺癌(NSCLC)患者同步放化疗(CCRT)疗效的评估价值。方法对我院呼吸科及胸心外科近三年(2015年1月～2018年1月)经病理证实为NSCLC的45例患者CCRT治疗前后采用MR-DWI及CTP检查。根据RECIST评价标准将患者分为有效组和无效组,比较两组患者治疗前后癌灶表观弥散系数(ADC)及CT灌注参数[血流量(BF)、血容量(BV)、平均通过时间(MTT)、表面渗透性(PS)、到达峰值时间(TTP)]变化,探讨肿瘤ADC值及CTP参数的相关性并分析DWI及CTP联合评估NSCLC患者CCRT疗效的价值。结果 (1)有效组患者31例,无效组14例。(2)DWI检测结果:与治疗前比较,有效组患者癌灶ADC值显著增高(P<0.05),无效组癌灶ADC值无显著变化(P>0.05);组间比较,有效组患者治疗后癌灶ADC值显著高于无效组治疗后(P<0.05)。(3)CTP检测结果:与治疗前比较,有效组癌灶BF值显著增高(P<0.05),MTT值显著降低(P<0.05),无效组CT灌注参数无显著变化(P>0.05);组间比较,有效组患者治疗后癌灶BF值显著高于无效组(P<0.05),MTT值显著低于无效组(P<0.05)。(3)肿瘤ADC值及CTP参数无明显相关性。结论 DWI及CTP均能反映NSCLC患者CCRT治疗后的疗效,且二者不能相互替换,若联合应用可更好评估患者早期放化疗效果。更多还原

【Abstract】 Objective To explore the evaluated value of diffusion-weighted imaging(DWI) and CT perfusion(CTP) in the concurrent chemoradiotherapy(CCRT) of patients with non-small cell lung cancer(NSCLC). Methods A total of 45 cases of patients pathologically confirmed with NSCLC in the respiratory department and cardiothoracic surgery of our hospital for the past three years(January 2015 to January 2018) were given MR-DWI and CTP before and after CCRT. According to the RECIST evaluation criteria, patients were divided into effective group and ineffective group. The lesion apparent diffusion coefficient(ADC) and CT perfusion parameters [blood flow(BF), blood volume(BV), and mean transit time(MTT), permeability surface(PS), time to peak(TTP)] were compared between the two groups before and after treatment. The correlation between tumor ADC value and CTP parameters was explored, and the value of DWI and CTP in the evaluation of CCRT efficacy of NSCLC patients was analyzed. Results There were 31 patients in effective group and 14 patients in ineffective group. DWI test showed compared with before treatment, the lesion ADC value was significantly increased in effective group(P<0.05), but there was no significant change in the ADC value in ineffective group(P>0.05). The lesion ADC value in effective group after treatment was significantly higher than that in ineffective group(P<0.05). CTP test showed compared with before treatment, the BF value was significantly increased in effective group(P<0.05) while the MTT value was significantly decreased(P<0.05), but there was no significant change in the CT perfusion parameters in ineffective group(P>0.05). The BF value in effective group was significantly higher than that in ineffective group(P<0.05) while the MTT value was significantly lower than that in ineffective group(P<0.05). There was no significant correlation between tumor ADC value and CTP parameters. Conclusion DWI and CTP can correctly evaluate the efficacy of CCRT in patients with NSCLC, and the two can not replace each other. If the combination can be used as a complementary technology, it can better evaluate the early chemoradiotherapy effects.更多还原