CAJ | 학술논문

目的探讨磁共振弥散成像在胶质瘤放射治疗早期疗效评价中的作用.方法人选初发的胶质瘤患者,术后给予肿瘤局部普通外放疗,在放疗前与放疗中期分别行弥散磁共振扫描,患者放疗结束后1个月再次行增强磁共振扫描判断其治疗效果.利用方差分析比较不同治疗效果患者间弥散磁共振参数是否有统计学意义,并进一步判断其敏感性与特异性.结果各疗效组患者治疗前病变ADC均值、治疗中ADC均值、ADC差值、治疗前累积ADC值、治疗中累积ADC值差异无统计学意义(P>0.05);PD组与PR组的ADC差值差异有统计学意义(P=0.041);各组患者的累积ADC变化百分比差异有统计学意义(P=0.000),组间比较差异均有统计学意义(P<0.05);利用累积ADC变化百分比早期判断这部分患者放疗疗效的正确性为92.7%,其发现进展病例的准确性与特异性分别为81.9%和96.2%.结论利用弥散磁共振技术可早期判定胶质瘤患者的放疗疗效,累积ADC变化百分比是预测胶质瘤放疗效果的可靠参数.
목적 탐토자공진미산성상재효질류방사치료조기료효평개중적작용.방법 인선초발적효질류환자,술후급여종류국부보통외방료,재방료전여방료중기분별행미산자공진소묘,환자방료결속후1개월재차행증강자공진소묘판단기치료효과.이용방차분석비교불동치료효과환자간미산자공진삼수시부유통계학의의,병진일보판단기민감성여특이성.결과 각료효조환자치료전병변ADC균치、치료중ADC균치、ADC차치、치료전루적ADC치、치료중루적ADC치차이무통계학의의(P>0.05);PD조여PR조적ADC차치차이유통계학의의(P=0.041);각조환자적루적ADC변화백분비차이유통계학의의(P=0.000),조간비교차이균유통계학의의(P<0.05);이용루적ADC변화백분비조기판단저부분환자방료료효적정학성위92.7%,기발현진전병례적준학성여특이성분별위81.9%화96.2%.결론 이용미산자공진기술가조기판정효질류환자적방료료효,루적ADC변화백분비시예측효질류방료효과적가고삼수.
Objective To evaluate the role of diffusion magnetic resonance imaging(MRI) in early detection of the treatment response of radiation for glioma. Method Conventional and diffusion MRI were acquired before and at 3 weeks later after initiating radiotherapy for newly diagnosed glioma patients,who had partial tumor resection. ANOVA was used to compare the diffusion MRI parameters among different treatment response groups. Receiver operating characteristic (ROC) curve was used for judgment of sensitivity and specificity of the parameters. Results There was no statistically significant differences (P>0.05) of the pretreatment apparent diffusion coefficient (ADC), ADC during treatment, ADC subtraction value, pretreatment accumulated ADC value,accumulated ADC value during treatment among partial response (PR) group, stable disease(SD) group and progressive disease (PD) group patients. There was statistical differences (P<0.05) of accumulated ADC change percentage among the groups. The predictive value and overall accuracy for early detection of treatment response by the accumulated ADC change percentage was 92.7%. The sensitivity and specificity for predicting PD patients were 81.9% and 96.2% respectively. Conclusions Diffusion MRI could predict the radiotherapy response of glioma patients. Accumulated ADC change percentage is a good parameter for the early detection of PD patients during the treatment of radiation.