磁共振T2WI、DWI对直肠癌新辅助治疗疗效的评估价值

doi:10.7517/issn.1674-0475.210727

摘要/Abstract

摘要： 本研究探讨磁共振成像T2WI、弥散加权成像（DWI）在直肠癌新辅助治疗疗效的评估价值。选取直肠癌患者92例，给予新辅助治疗，比较治疗前后T2WI、DWI参数变化。治疗无效患者治疗后肿瘤绝对信号值（SIT）明显高于治疗有效患者（P<0.05），而肿瘤绝对信号值减低率（SITRR）、治疗后肿瘤相对信号值（SIT/M）、肿瘤相对信号值减低率（SIT/MRR）明显低于治疗有效患者（P<0.05）；治疗无效患者治疗后表观扩散系数（ADC）值、ADC变化值明显低于治疗有效患者（P<0.05）；治疗后SIT、SITRR、SIT/MRR预测治疗有效的ROC曲线下面积分别为0.671、0.950和0.879（P<0.05）；治疗后ADC值、ADC变化值预测治疗有效的ROC曲线下面积分别为0.717和0.977（P<0.05）。磁共振T2WI图像参数、ADC在预测直肠癌新辅助治疗疗效中有较高的应用价值。

关键词: T2WI, 弥散加权成像, 直肠癌, 新辅助治疗, 预测价值

Abstract: This study explores the evaluation value of the efficacy of T2WI, dispersion-weighted imaging (DWI) in the neoadjuvant treatment of rectal cancer. 92 patients with rectal cancer treated were selected and given neoadjuvant therapy, the changes of T2WI and DWI parameters before and after treatment were compared. The signal intensity of tumor value (SIT) after treatment of the patients with ineffective treatment was significantly higher than that of the patients with effective treatment (P<0.05), the signal intensity of tumor reduction rate (SITRR), signal intensity of tumor/muscle value (SIT/M) after treatment and signal intensity of tumor/muscle reduction rate (SIT/MRR) were significantly lower than those of effective patients (P<0.05). After treatment, apparent diffusion coefficient (ADC) value and ADC change value in ineffective patients were significantly lower than those of effective patients (P<0.05). The area under the ROC curve of SIT after treatment, SITRR and SIT/MRR to predicts therapeutic efficacy was 0.671, 0.950 and 0.879, respectively (P<0.05). The areas under the ROC curve of ADC value after treatment and ADC change value to predicts therapeutic efficacy were 0.717 and 0.977, respectively (P<0.05). Magnetic resonance T2WI image parameters and ADC have high application value in predicting the efficacy of neoadjuvant therapy for rectal cancer.

Key words: T2WI, diffusion weighted imaging, rectal cancer, neoadjuvant therapy, predictive value

肖欢, 赵振华, 周莹, 谢梦雨, 刘启榆. 磁共振T2WI、DWI对直肠癌新辅助治疗疗效的评估价值[J]. 影像科学与光化学, 2022, 40(1): 151-155.

XIAO Huan, ZHAO Zhenhua, ZHOU Ying, XIE Mengyu, LIU Qiyu. Evaluation of T2WI and DWI in Neoadjuvant Therapy for Rectal Cancer[J]. IMAGING SCIENCE AND PHOTOCHEMISTRY, 2022, 40(1): 151-155.

参考文献

[1] 臧书芹, 沈浮, 郝强. 磁共振影像组学主成分分析法预测直肠癌新辅助放射化学治疗效果[J]. 第二军医大学学报, 2020, 41(3):325-329.
[2] Dagoglu R N, Chen Y H, Boyle P J, et al. Lymph node retrieval following neoadjuvant therapy in patients with rectal cancer:Does it affect the predictability of neoadjuvant rectal cancer (NAR) score?[J]. International Journal of Radiation Oncology Biology Physics, 2020, 108(3):e638.
[3] 周一芦, 房静远. 结直肠癌发生部位与肠道菌群的关系以及未来展望[J]. 中华内科杂志, 2021, 60(6):585-588.
[4] Recio-Boiles A, Hammad H, Howell K, et al. Locally advanced rectal cancer evaluation by magnetic resonance imaging after neoadjuvant therapy on decision making:Cancer center experience and literature review[J]. Journal of Gastrointestinal Cancer, 2020, 51(1):254-259.
[5] Danihel L, Rajcok M, Mosna K, et al. MRI-based neoadjuvant therapy indication in middle and low rectal cancer[J]. Bratislavske Lekarske Listy, 2019, 120(9):663-667.
[6] Fukuoka T, Maeda K, Nagahara H, et al. Change in PMI during neoadjuvant therapy is a predictive prognostic marker in rectal cancer[J]. Anticancer Research, 2019, 39(9):5157- 5163.
[7] Mroczkowski P, Dziki L. Total neoadjuvant therapy in rectal cancer-improvement or overtreatment?[J]. British Journal of Surgery, 2019, 106(11):1558.
[8] Maas M, Dijkhoff R A P, Beets-Tan A R. Rectal cancer:Assessing response to neoadjuvant therapy-science direct[J]. Magnetic Resonance Imaging Clinics of North America, 2020, 28(1):117-126.
[9] Avant A, Olsen J R. Optimizing rectal cancer neoadjuvant therapy-how to manage a cCR?[J]. International Journal of Radiation Oncology, Biology, Physics, 2020, 106(4):669-670.
[10] Ngoo A G, Tan A H M, Mushaya C D, et al. Short and long course neoadjuvant therapy compared for management of locally advanced rectal cancer:11 years' experience at a regional centre[J]. ANZ Journal of Surgery, 2020, 90(5):812-820.
[11] Santiago I, Barata M, Figueiredo N, et al. The split scar sign as an indicator of sustained complete response after neoadjuvant therapy in rectal cancer[J]. European Radiology, 2020, 30(1):224-238.
[12] 马颖, 赵莲萍, 黄刚. 基于磁共振图像影像组学对直肠癌新辅助放化疗疗效评估的研究进展[J]. 磁共振成像, 2020, 11(10):947-949.
[13] 李戟玭, 毛蕾, 周雪婷, 等. 磁共振成像评估直肠癌新辅助治疗后疗效的研究进展[J]. 磁共振成像, 2021, 12(4):121-124.
[14] 许宁, 黄凤昌, 李文亮, 等. 磁共振肿瘤退缩分级和表观弥散系数对局部进展期直肠癌新辅助治疗后病理完全缓解的预测价值[J]. 中华胃肠外科杂志, 2021, 24(4):359-365.
[15] 陆海迪, 沈浮, 陆建平, 等. 基于磁共振高分辨T2WI影像组学预测直肠癌新辅助治疗后病理完全反应的研究[J]. 国际肿瘤学杂志, 2020, 47(10):593-597.