【摘要】 目的：旨在探讨磁共振弥散加权成像技术在评估食管鳞癌对新辅助放化疗病理反应的预测价值。方法：回顾性分析2013年12月—2016年6月在河南省肿瘤医院行新辅助放化疗的19例食管鳞癌患者的一般资料，分期为cT2-4aN1-3M0或cT3N0M0。所有患者均在放化疗前及结束后1周内进行磁共振检查，在治疗完成后3～4周，患者均接受食管癌切除术。评估表现扩散系数（ADC值）在预测不同病理缓解程度[肿瘤退缩等级（TRG）]中的作用。结果：12例（63.2%）患者显示出有病理缓解反应，其中8例（42.1%）达到病理缓解良好。相较于无病理缓解组，有病理缓解组的ADCpre值明显升高，差异有统计学意义（P<0.05）。当ADCpre的临界值为1.77×10^-3mm²/s时，其对预测病理缓解反应的敏感度、特异度分别达到83.33%和71.43%。结论：磁共振弥散加权成像有可能成为预测食管鳞状细胞癌新辅助放化疗后病理缓解反应的一个有前景的影像学检查方法。更多还原

【Abstract】 Objective:To explore the predictive value of magnetic resonance diffusion-weighted imaging in assessing the pathological response of esophageal squamous cell carcinoma to neoadjuvant chemoradiotherapy.Methods:A retrospective analysis was conducted on the medical records of 19 patients with esophageal squamous cell carcinoma who underwent neoadjuvant chemoradiotherapy at Henan Provincial Cancer Hospital from December 2013 to June 2016. The patients were staged as cT2-4 aN1-3M0 or cT3N0M0. All patients underwent magnetic resonance imaging（MRI） within one week before and after chemoradiotherapy. Three to four weeks after completion of treatment, patients underwent esophageal cancer resection. The role of apparent diffusion coefficient（ADC） values in predicting different degrees of pathological response [tumor regression grade（TRG）1-3 indicates pathological response, TRG 1-2 indicates good pathological response] was evaluated.Results:There were 12 patients（63.2%） demonstrated pathological response, and 8 patients（42.1%） achieving good pathological response. Compared with the group without pathological response, the AD Cpre value was significantly higher in the group with pathological response(2.31±0.53×10^-3mm²/s vs. 1.72±0.40×10^-3mm²/s, P=0.021). When the cutoff value for ADCpre was set at 1.77×10^-3mm²/s, its sensitivity and specificity for predicting pathological response were 83.33% and 71.43%, respectively.Conclusion:Magnetic resonance diffusion-weighted imaging may become a promising imaging method for predicting pathological response to neoadjuvant chemoradiotherapy in esophageal squamous cell carcinoma.更多还原