目的 评估应用磁共振弥散加权成像表观弥散系数(ADC)预测和早期监测肝转移瘤化疗疗效的可行性.方法 选择43例原发肿瘤为胃肠道、乳腺或其他部位的肝转移瘤患者,在化疗前和化疗后2～3周常规检查弥散加权成像并获得相应的ADC值.采用RECIST作为评价肝转移肿瘤化疗疗效的标准.结果 在43例肝转移瘤68个病灶中,30个病灶对化疗有效,38个病灶对化疗无效,其治疗前平均ADC值分别为1.22±0.39×10-3 mm2/s和1.54±0.55×10-3 mm2/s(P=0.008)；在治疗后2周,化疗有效组ADC值升至1.43×103mm2/s(P=-0.005),而化疗无效则降至1.23×10-3mm2/s(P=0.13)；以ADC值=1.50×10-3mm2/s为治疗有效或无效的临界点,其判断疗效的阳性预测值为94％,阴性预测值为92％,准确率为93％.结论 磁共振弥散加权成像ADC可作为预测肝转移瘤化疗疗效的影像学指标.%Objective To investigate the feasibility of apparent diffusion coefficients (ADC) in diffusion weighted MR imaging in predicting response to chemotherapy in patients with hepatic metastatic tumors. Methods Forty-three consecutive patients with hepatic metastases from gastric and colorectal cancer, breast cancer and other tumors underwent MRI diffusion-weighted imaging (DWI) sequences before and 2 to 3 weeks following chemotherapy for assessing the ADC value of lesions. RECIST was utilized to evaluate the efficacy of the chemotherapy. Results A total of 68 lesions in the 43 patients were observed,and the sizes of hepatic metastases decreased in 30 ones (the respond group) and increased or did not change in 38 ones (the non-respond group) after chemotherapy. The mean ADC values of lesions were 1.22 ±0.39 × 10-3 mm2/s in the respond group and 1.54 ± 0.55 × 10-3 mm2/s in the non-respond group (P=0.008) .respectively; After treatment, the ADC values increased to 1.43 ×10×3 mm2/s (P=0.005) in the responders,whereas they decreased to 1.23 × 10-1 mm2/s (P<0.13) in the non-responders; We supposed ADC equal to 1.50 × 10-3 mm2/s as a threshold value for responders and non-responders, the positive predictive value, negative predictive value and accuracy were 94% ,92% and 93%, respectively. Conclusion ADC value of diffusion weighted MR imaging was potential to be an imaging marker for predicting and assessing early chemotherapeutic responses of hepatic metastases.
展开▼
