弥散加权成像预测食管鳞癌患者放化疗近期疗效的临床价值

目的 探讨磁共振弥散加权成像(DWI)在食管鳞癌(ESCC)患者放化疗近期疗效预测中的作用.方法 回顾性收集2017年4月至2020年3月承德市第三医院收治的120例ESCC患者,患者放化疗前后均进行DWI扫描,在DWI图像上对病灶表观扩散系数(ADC)进行测量.根据放化疗近期疗效将患者分为缓解组(完全缓解+部分缓解)...

The clinical value of diffusion-weighted imaging in predicting the short-term efficacy of radiotherapy and chemotherapy in patients with esophageal squamous cell carcinoma

Objective To investigate the role of magnetic resonance diffusion weighted imaging(DWI)in predicting the short-term efficacy of radiotherapy and chemotherapy in patients with esophageal squamous cell carcinoma(ESCC).Methods A total of 120 patients with ESCC admitted to the Third Hospital of Chengde City from April 2017 to March 2020 were retrospectively collected.DWI scanning was performed before and after radiotherapy and chemotherapy,and the apparent diffusion coefficient(ADC)of the lesion was measured on DWI images.According to the short-term efficacy of radiotherapy and chemotherapy,the patients were divided into remission group(complete remission+partial remission)and non-remission group(progression+stability).The ADC value,ADC value change(ΔADC)and ADC value change rate(ADC%)before and after radiotherapy and chemotherapy were compared between the two groups.The ADC values of the complete remission group and the partial remission group before and after radiotherapy and chemotherapy were compared.The receiver operating characteristic curve(ROC)was used to evaluate the predictive value of ADC value before treatment for the efficacy of radiotherapy and chemotherapy.Results Among 120 patients,complete remission 31 cases(25.83%),partial remission 48 cases(40.00%),stability 32 cases(26.67%),progression 9 cases(7.50%).There were 79 cases in the remission group and 41 cases in the non-remission group.The ADC value of 120 patients after radiotherapy and chemotherapy was(2.13±0.26)×10^-3mm²/s,which was significantly higher than before treatment(1.45±0.18)×10^-3mm²/s],the difference was statistically significant(P<0.05).The ADC value of remission group was significantly lower than that of non-remission group before treatment,and the ADC value of remission group was significantly higher than that of non-remission group after treatment,the differences were statistically significant(P<0.05).Compared with the non-relieving group,theΔADC and ADC%of the remission group before and after radiotherapy and chemotherapy were significantly increased,the differences were statistically significant(P<0.05).Before radiotherapy and chemotherapy,the ADC value of complete remission group was significantly lower than that of partial remission group,while after radiotherapy and chemotherapy,the ADC value of complete remission group was significantly higher than that of partial remission group,the differences were statistically significant(P<0.05).Before treatment,ADC values predicted that the area under the ROC curve the remission of radiotherapy and chemotherapy in ESCC patients was 0.843(95%CI:0.765-0.903),the sensitivity was 92.41%,and the specificity was 65.85%.The area under the ROC curve for predicting complete remission was 0.901(95%CI:0.833-0.948),with a sensitivity of 96.77%and a specificity of 74.16%.Conclusion ADC value before treatment has a good predictive value for the short-term efficacy of radiotherapy and chemotherapy in patients with ESCC.DWI can be used as an imaging method for evaluating the efficacy of ESCC patients.