中华胃肠外科杂志
中華胃腸外科雜誌
중화위장외과잡지
CHINESE JOURNAL OF GASTROINTESTINAL SURGERY
2013年
12期
1164-1168
,共5页
曹务腾%周智洋%邓艳红%康亮%练延帮%邱建平%龚佳英%熊斐%李文儒
曹務騰%週智洋%鄧豔紅%康亮%練延幫%邱建平%龔佳英%熊斐%李文儒
조무등%주지양%산염홍%강량%련연방%구건평%공가영%웅비%리문유
直肠肿瘤%新辅助治疗%病理完全缓解%磁共振成像%扩散加权成像
直腸腫瘤%新輔助治療%病理完全緩解%磁共振成像%擴散加權成像
직장종류%신보조치료%병리완전완해%자공진성상%확산가권성상
Rectal neoplasms%Neoadjuvant therapy%Pathological complete response%Magnetic resonance imaging%Diffusion weighted imaging
目的 探讨磁共振扩散加权成像(DWI)结合常规T2WI序列对直肠癌新辅助治疗后病理完全缓解(pCR)的预测价值.方法 回顾性分析2012年6月至2013年4月间在中山大学附属第六医院直肠癌诊疗中心接受新辅助治疗加根治性切除术的51例局部进展期中低位直肠癌患者的临床资料,所有患者均于新辅助治疗前1周内和术前1周内行磁共振DWI和T2WI两种序列扫描成像,分别采用T2WI序列和DWI结合T2WI序列两种方法主观评价肿瘤有无残留,并与术后病理结果对照,比较两种方法对pCR的预测价值.结果 51例患者中12例(23.5％)获得pCR.DWI结合T2WI序列正确预测pCR 8例,其预测敏感性和特异性分别为66.7％(8/12)和94.9％(37/39);单独采用T2WI序列正确预测pCR 4例,其预测敏感性和特异性分别为33.3％(4/12)和84.6％(33/39);前者对pCR的预测价值明显高于后者(曲线下面积分别为0.808和0.590,P=0.001).结论 与单独应用T2WI序列相比,DWI结合T2WI序列能更加准确地对pCR进行预测.
目的 探討磁共振擴散加權成像(DWI)結閤常規T2WI序列對直腸癌新輔助治療後病理完全緩解(pCR)的預測價值.方法 迴顧性分析2012年6月至2013年4月間在中山大學附屬第六醫院直腸癌診療中心接受新輔助治療加根治性切除術的51例跼部進展期中低位直腸癌患者的臨床資料,所有患者均于新輔助治療前1週內和術前1週內行磁共振DWI和T2WI兩種序列掃描成像,分彆採用T2WI序列和DWI結閤T2WI序列兩種方法主觀評價腫瘤有無殘留,併與術後病理結果對照,比較兩種方法對pCR的預測價值.結果 51例患者中12例(23.5％)穫得pCR.DWI結閤T2WI序列正確預測pCR 8例,其預測敏感性和特異性分彆為66.7％(8/12)和94.9％(37/39);單獨採用T2WI序列正確預測pCR 4例,其預測敏感性和特異性分彆為33.3％(4/12)和84.6％(33/39);前者對pCR的預測價值明顯高于後者(麯線下麵積分彆為0.808和0.590,P=0.001).結論 與單獨應用T2WI序列相比,DWI結閤T2WI序列能更加準確地對pCR進行預測.
목적 탐토자공진확산가권성상(DWI)결합상규T2WI서렬대직장암신보조치료후병리완전완해(pCR)적예측개치.방법 회고성분석2012년6월지2013년4월간재중산대학부속제륙의원직장암진료중심접수신보조치료가근치성절제술적51례국부진전기중저위직장암환자적림상자료,소유환자균우신보조치료전1주내화술전1주내행자공진DWI화T2WI량충서렬소묘성상,분별채용T2WI서렬화DWI결합T2WI서렬량충방법주관평개종류유무잔류,병여술후병리결과대조,비교량충방법대pCR적예측개치.결과 51례환자중12례(23.5％)획득pCR.DWI결합T2WI서렬정학예측pCR 8례,기예측민감성화특이성분별위66.7％(8/12)화94.9％(37/39);단독채용T2WI서렬정학예측pCR 4례,기예측민감성화특이성분별위33.3％(4/12)화84.6％(33/39);전자대pCR적예측개치명현고우후자(곡선하면적분별위0.808화0.590,P=0.001).결론 여단독응용T2WI서렬상비,DWI결합T2WI서렬능경가준학지대pCR진행예측.
Objective To evaluate the application value of magnetic resonance diffusionweighted imaging (DWI) combined with routine T2WI sequence in the determination of pathological complete response(pCR) after neoadjuvant therapy for rectal cancer.Methods Clinical data of 51 cases with locally advanced mid-low rectal cancer undergoing neoadjuvant therapy plus radical resection in the Rectal Cancer Center at The Sixth Affiliated Hospital of Sun Yat-sen University from June 2012 to April 2013 were analyzed retrospectively.Magnetic resonance DWI and T2WI sequences scanning were performed within 1 week before neoadjuvant therapy and within 1 week before operation.Routine single T2WI sequence and DWI combined with T2WI sequence were used separately to predict the residual tumor and to compare with postoperative pathological examination.The prediction values of two methods were compared.Results Of 51 patients,12 cases had pathological complete response(pCR).Prediction of DWI combined T2WI sequence was correct in 8 cases of pCR,whose sensitivity and specificity were higher than those of routine single T2WI sequence (66.7％,94.9％ vs.33.3％,84.6％).Prediction value of DWI combined T2WI sequence for pCR was significantly higher as compared to routine single T2WI sequence (AUC,0.808 vs.0.590,P=0.001).Conclusion Compared with the routine single T2WI sequence,DWI combined with T2WI sequence can improve the prediction accuracy of pathological complete response.
