MRI常规序列评估胰腺癌化疗后的疗效

目的 探讨MRI常规序列在胰腺癌化疗后疗效评估中的应用价值.资料与方法 回顾性分析经病理证实、接受系统化疗的51例胰腺癌患者的MRI资料,分析其治疗前后肿瘤大小、信号特点和强化特征等,采用RECIST 1.1标准进行胰腺癌化疗后疗效评估.结果 42例治疗前信号均匀或相对均匀,9例为不均匀囊实性肿块.治疗后,30例信号由均匀或相对均匀变为不均匀;13例强化特征发生明显变化,其中8例治疗后肿瘤强化程度增强,5例强化程度减弱;17例胰周脂肪间隙较治疗前清晰.通过瘤体单一长径测量,51例患者中客观疗效为部分缓解14例,疾病稳定20例,疾病进展17例.结论 MRI常规序列胰腺癌靶病灶径线的测量、信号特点和强化特征可用于评估胰腺癌化疗后的疗效.

Evaluation of Conventional MRI Sequences for Post Chemotherapy Response in Pancreatic Carcinoma

Purpose To investigate conventional MRI sequences for evaluating post chemotherapy response in pancreatic carcinoma.Materials and Methods 51 patients with pathology-proven pancreatic carcinoma were analyzed after systematic chemotherapy.All cases were examined with plain and enhanced MRI scan.The MRI appearance including size,signal characteristics and enhancement features were reviewed and the response was determined according to revised response evaluation criteria in solid tumor(RECIST 1.1).Results Homogeneous signal was demonstrated in 42 patients and heterogeneous signal in 9 cases.After chemotherapy,the signal intensity became heterogeneous in 30 patients.Significant change of enhancement features occurred in 13 patients after chemotherapy.Peripancreatic fat stranding disappeared in 17 patients.Based on the greatest dimension of the tumor,14 of 51 cases showed partial response(PR),20 cases were stable disease(SD),and 17 cases were progressive disease(PD).Conclusion Measuring the dimension of the tumor,the characteristics of signals and enhancement on conventional MRI sequences can be used to evaluate response after chemotherapy in pancreatic carcinoma.