论文部分内容阅读
目的:探讨晚期宫颈癌患者新辅助化疗前后局部磁共振灌注成像(MR-PWI)的改变是否与实体瘤客观疗效标准(RECIST)标准判断一致。方法:对31例经病理确诊的宫颈癌患者依据RECIST标准判断,分为化疗有反应组和无反应组,分别在行新辅助化疗前和两次化疗(5周)后进行MR灌注扫描,观察病灶的形态和灌注表现,绘制感兴趣区,获得时间-信号强度曲线(TIC)和病灶相对强化百分比(percentage of relative enhancement,PRE)和最大强化百分比(percentage of maximum enhancement,PME),曲线下面积(area under the curve,AUC),使用统计软件分析比较化疗前后肿瘤灌注值改变。结果:依据RECIST标准判断31例中,有反应组24例(23例部分缓解,1例完全缓解),无反应组7例(5例稳定,2例进展),共收集到24例肿瘤反应组病例,追踪到其手术根治,MR PWI观察到有反应组化疗前肿瘤PRE和PME分别为(228.54±61.83)和(2 405.61±758.29),化疗后肿瘤分别为(142.85±43.26)和(1 659.18±597.37),差异有统计学意义(P<0.05);有反应组肿瘤AUC化疗前为(291 323.70±10 956.80),化疗后为(168 952.8±67 214.02),差异有统计学意义(P<0.05)。无反应组化疗前肿瘤PRE和PME分别为(175.65±10.43)和(2 085.31±133.12),化疗后为(164.92±24.43)和(2 224.18±209.95),差异无统计学意义(P>0.05);无反应组化疗前肿瘤AUC为(241 469.28±14 517.16),化疗后肿瘤AUC为(262 993.85±27 119.08),差异无统计学意义(P>0.05)。结论:MR-PWI改变与RECIST标准判断相符合,可作为常规影像评价的补充方法。
Objective: To investigate whether MR-PWI changes in patients with advanced cervical cancer before and after neoadjuvant chemotherapy are consistent with RECIST criteria. Methods: According to the RECIST criteria, 31 patients with pathologically diagnosed cervical cancer were divided into chemotherapy group and non-response group. MR perfusion scanning was performed before neoadjuvant chemotherapy and after two cycles of chemotherapy (5 weeks), respectively The morphology and perfusion of the lesion were observed and the region of interest was plotted to obtain the time-signal intensity curve (TIC) and percentage of relative enhancement (PRE) and percentage of maximum enhancement (PME). The area under the curve (area under the curve, AUC). Statistical software was used to analyze the change of tumor perfusion before and after chemotherapy. RESULTS: According to the RECIST criteria, there were 24 cases in response group (23 cases partially relieved and 1 case completely relieved) and 7 cases in non-reaction group (5 cases were stable and 2 cases progressed) The cases were followed up for radical surgery. The PRE and PME of MR PWI in response group were (228.54 ± 61.83) and (2 405.61 ± 758.29), respectively. The tumors after chemotherapy were (142.85 ± 43.26) and (1659.18 ± 597.37), the difference was statistically significant (P <0.05). The response rate of tumor in response group before chemotherapy (291 323.70 ± 10 956.80) and after chemotherapy was (168 952.8 ± 67 214.02), the difference was statistically significant (P < 0.05). The PRE and PME of non-response group were (175.65 ± 10.43) and (2 085.31 ± 133.12) and (164.92 ± 24.43) and (2 224.18 ± 209.95) after chemotherapy, respectively, with no significant difference (P> 0.05) The AUC of non-response group before chemotherapy was (241 469.28 ± 14 517.16) and the tumor AUC after chemotherapy was (262 993.85 ± 27 119.08), with no significant difference (P> 0.05). Conclusion: The change of MR-PWI is consistent with RECIST standard judgment, which can be used as a supplementary method for routine imaging evaluation.