摘要
目的:探索磁共振扩散加权成像表观扩散系数(ADC)值在预测及早期评估乳腺癌肝转移(BCLM)化疗效果中的作用。方法:选择42例乳腺癌肝转移患者,分别于化疗前3 d、化疗后1周、2周及4周进行常规MRI及扩散加权成像(DWI),并测量病灶的ADC值。采用实体肿瘤疗效评价标准(RECIST)作为评价乳腺癌肝转移化疗疗效的评价标准。结果:42例乳腺癌肝转移患者86个病灶中,40个病灶对化疗有效,46个病灶对化疗无效。化疗前有效组ADC值((1.06±0.07)×10^(-3)mm^2/s)明显低于无效组((1.22±0.14)×10^(-3)mm^2/s),且差异具有统计学意义(P<0.05);化疗后1周,有效组ADC值((1.08±0.13)×10^(-3) mm^2/s,P=0.144)较化疗前有所增加,无效组ADC值((1.20±0.16)×10^(-3)mm^2/s,P=0.179)较化疗前有所降低,两者间差异均无明显统计学意义;化疗后2周及4周,有效组ADC值((1.28±0.11)×10^(-3)mm^2/s,(1.36±0.10)×10^(-3)mm^2/s)较化疗前明显增高且差异有统计学意义(P<0.05),而无效组无明显变化。ROC曲线下面积为0.846,以治疗前ADC=1.11×10^(-3) mm^2/s作为判断化疗是否有效的界值,其敏感性与特异性为78.3%和87.5%。结论:治疗前ADC值结合治疗后2周ADC值有助于早期预测及评价BCLMs的化疗疗效。
Objective： To determine whether change of apparent diffusion coefficient（ADC） values could predict early response to chemotherapy in breast cancer liver metastases（BCLM）. Methods： We retrospectively studied 42 patients with BCLMs（86 lesions） who had undergone conventional MRI and DWI at 3 days before chemotherapy and 1 week, 2 weeks, 4 weeks after chemotherapy. Selected patients were divided into responders（R） and non-responders（NR）. The grouping reference was based on MRI according to response evaluation criteria in solid tumors（RECIST）. Results： Eighty-six metastases were classified as 40 R and 46 NR. The difference in maximum tumor diameter of R group between pre-chemotherapy and 4 weeks after chemotherapy was significant（P〈0.05）. Pretreatment mean ADC（（1.06±0.07）×10-3 mm2/s） of R group was significantly lower than that of NR group（（1.22±0.14）×10-3 mm2/s）（P〈0.05）. After 1 week of chemotherapy, the mean ADC of R group increased slightly and the mean ADC of NR group decreased slightly, with no statistical significance. After 2 weeks and 4 weeks of chemotherapy, the mean ADC of R group increased significantly but not in NR group. The results of ROC curve showed that areas of under the curve were 0.846, pretreatment ADC of 1.11×10-3 mm2/s concluded BCLMs to chemotherapy ineffective sensitivity and specificity value were 78.3% and 87.5%, respectively. Conclusion： The pretreatment and 2 weeks after treatment ADC value may be helpful to predict early response to chemotherapy in BCLM.
出处
《中国临床医学影像杂志》
CAS
北大核心
2017年第3期180-183,共4页
Journal of China Clinic Medical Imaging
关键词
乳腺肿瘤
肝肿瘤
肿瘤转移
磁共振成像
Breast neoplasms
Liver neoplasms
Neoplasms metastasis
Magnetic resonance imaging
作者简介
王亚婷（1990-），女，江苏人，在读硕士研究生。E—mail：593793621@qq．com
[通讯作者]柏根基，南京医科大学附属淮安第一医院影像科，223300。E-mail：hybgj0451@163．com.
