MR扩散加权成像评价膀胱癌经动脉灌注化疗及栓塞术后疗效的价值

目的探讨MR扩散加权成像(DWI)在膀胱癌经髂内动脉灌注化疗及栓塞术后疗效评价中的作用。资料与方法对经病理证实的28例膀胱移行上皮细胞癌患者于介入术前后行MR DWI。在GE Signa Excite HD 1.5TMR扫描仪上,先取多个扩散敏感梯度因子(b值)分别为300 s/mm2、500 s/mm2、800 s/mm2、1000 s/mm2、1200 s/mm2、1500 s/mm2,利用固定参数组合的自旋回波-回波平面成像(SE-EPI)序列对28例经动脉灌注化疗及栓塞术的膀胱癌肿块分别于术前24～48 h、术后7～10天各进行一次多b值的DWI。经分析比较后选取合适的b值为1200s/mm2,测量出每例膀胱癌不同监测时间点的肿瘤平均表观扩散系数(ADC)值,对两组结果进行比较。结果 28例膀胱肿瘤治疗前平均ADC值(1.15±0.12)×10-3mm2/s,介入治疗后肿瘤平均ADC值(1.36±0.15)×10-3mm2/s,治疗后肿瘤平均ADC值升高,P值<0.05,差异具有统计学意义。结论初步研究表明,对膀胱肿瘤的ADC值进行动态测定,可以评价膀胱癌介入治疗后早期病理学反应。

The Value of Diffusion-Weighted MR Imaging in Evaluation of the Response to Intra-Arterial Infusion Chemotherapy and Embolization in Bladder Cancer

Objective To evaluate therapeutic effect of intra-arterial infusion chemotherapy and embolization with the diffusion-weighted MR Imaging(DWI)in bladder cancer(BC).Materials and Methods DWI was performed in 28 patients with pathologically diagnosed transitional cell carcinomas of the urinary bladder.Multi-b value DWI was performed at 1.5 T MRI.DWI and the measurement of apparent diffusion coefficient(ADC) value were performed in 28 cases of BC with the same SE-EPI sequence at 1.5 T MRI within the 24-48 hours...