摘要
目的探究动态增强磁共振成像(DCE-MRI)联合纹理参数评价食管癌放疗疗效的价值。方法搜集2016年7月4日至2018年6月20日在本院采用相同放疗并行同步化疗治疗方案的32例食管鳞状细胞癌患者的临床资料及放疗中的胸部MRI平扫和DCE-MRI检查资料,根据实体肿瘤疗效评估标准(RECIST)确定完全缓解(CR)组和部分缓解(PR)组病例各16例。比较CR组和PR组的血管渗透性参数:容积转运常数(Ktrans),速率常数(Kep),血管外细胞外间隙容积分数(Ve)。纹理参数:能量(Energy),熵(Entropy),相关(Correlation)对放疗疗效的评估效能,并行统计学检验。结果纳入本研究患者共计32例,男20例,女12例,平均年龄(62±12)岁。其中CR组共计16例,PR组共计16例,首次放疗前CR组患者与PR组患者Ktrans差异无统计学意义(0.4541±0.2133,0.4448±0.1624,P=0.867);末次放疗后CR组Ktrans低于PR组Ktrans,差异具有统计学意义(0.1174±0.0648,0.2987±0.2309,P=0.002)。首次放疗前CR组Kep与PR组患者差异无统计学意义(0.7713±0.4120,0.8494±0.4323,P=0.838);末次放疗后CR组Kep与PR组患者差异无统计学意义(0.3950±0.2544,0.5116±0.3871,P=0.491)。首次放疗前CR组Ve与PR组患者差异无统计学意义(0.3881±0.1070,0.3516±0.0579,P=0.239);末次放疗后CR组Ve低于PR组Ve,差异具有统计学意义(0.1428±0.0946,0.3221±0.2047,P=0.004)。首次放疗前CR组Energy与PR组患者差异无统计学意义(0.0273±0.0105,0.0278±0.0085,P=0.669);末次放疗后CR组Energy与PR组差异无统计学意义(0.0202±0.0067,0.0635±0.0605,P=0.239)。首次放疗前Entropy在CR组和PR组无统计学差异(5.775±0.4401,5.7788±0.3476,P=0.985);末次放疗后CR组Entropy低于PR组,差异具有统计学意义(6.0838±0.4415,6.7770±0.8271,P=0.047)。放疗前以及放疗后CR组Correlation与PR组差异无统计学意义(P=0.696,P=0.341)。CR组与PR组中有统计学差异的血管渗透性参数Post Ktrans参数的曲线下面积(AUC)为0.813,Post Ve参数的AUC为0.789,CR组与PR组中有统计学差异的纹理参数Post Entropy参数的AUC为0.707。结论DCE-MRI联合纹理分析可在治疗中较早地评估放疗疗效,以便及时调整下一步治疗方案。
Objective to explore whether the efficacy of radiotherapy and chemotherapy for esophageal cancer can be e-valuated by multi-phase dynamic contrast enhancement(DCE-MRI)combined with texture extraction parameters based on DCE-MRI arterial enhanced images.Methods 36 patients with esophageal squamous cell carcinoma(SCC)who were treatedin our hospitalbetween July 4,2016 and June 20,2018,were selected.All patients were treated with the same che-moradiotherapy regimen.All patients underwent chest MRI plain scan and DCE-MRI examination during radiotherapy.Ac-cording to the evaluation criteria of radiotherapy efficacy,16 cases of complete remission(CR)and 16 cases of partial re-mission(PR)were determined respectively,which were then divided into the CR and combined PR group.Vascular per-meability parameters of the comparison of CR and PR group were:solvent transfer constant Ktrans,rate constant Kep,blood vessels outside the extracellular clearance volume ratio(Ve).The texture parameters were:Energy,Entropy,Correlation performance to evaluate the efficacy of radiation and chemotherapy.Results A total of 32patients were included in the study,including 20 male patients and 12 female patients with an average age of 62±12 years.There were 12 patients in CR group and 12 patients in PR group.In this study,there was no statistically significant difference in Ktrans between CRgroup and PR group before discharge(P>0.05).After the final radiotherapy,Ktrans in CR group was lower than that in PR group,with statistically significant difference(P<0.05).Before radiotherapy,there was no statistically significant difference between patients in CR group and PR group(P>0.05).There was no statistically significant difference be-tween CR group Kep and PR group after radiotherapy(P>0.05).Before radiotherapy,there was no statistically signifi-cant difference between Ve group and PR group in CR group(P>0.05).After radiotherapy,Ve in CR group was lower than that in PR group,and the difference was statistically significant(P<0.05).Before radiotherapy,there was no sta-tistically significant difference between CR group and PR group(P>0.05).There was no statistically significant differ-ence between CR group and PR group after radiotherapy(P>0.05).Before radiotherapy,there was no significant differ-ence between CR group and PR group,P>0.05).Entropy in CR group after radiotherapy was lower than that in PR group,with a statistically significant difference of(P<0.05).Correlation between CR group and PR group before and af-ter radiotherapy showed no statistically significant difference(P>0.05).The AUC of Post Ktrans parameter,Post Ve pa-rameter and post entro1py parameter in CR group and PR group with statistical difference were 0.813,0.789 and 0.707,re-spectively.Conclusion DCE-MRI combined with texture analysis can predict the curative effect early in the treatment.
作者
李军
刘余民
程海平
毛椿平
刘方超
LI Jun;LIU Yumin;CHENG Haiping(Department of Radiology,Jingmen No.1 People’s Hospital,Jingmen 448000,P.R.China)
出处
《临床放射学杂志》
CSCD
北大核心
2019年第12期2317-2321,共5页
Journal of Clinical Radiology
关键词
食管癌
放疗
动态增强磁共振成像
纹理分析
esophageal cancer
Radiotherapy and chemotherapy
DCE-MRI
Texture analysis
作者简介
通讯作者:李军。
