CAJ | 학술논문

目的：探讨应用MR扩散加权成像（ DWI）技术监测肿瘤ADC值变化对早期评价淋巴瘤化疗疗效的价值。方法收集38例经病理检查证实的淋巴瘤患者，分别于化疗前、化疗后半个月（第1、3、5、9、13、15天）及化疗结束时（约30天检查），接受DWI扫描并测量ADC值；同时在化疗前、化疗后第15天、化疗结束时三个时间点增加横轴位T1 WI及T2 WI扫描以测量肿瘤的最大直径（长径）。按RESIST标准根据肿瘤化疗前、化疗结束时最大直径变化情况将研究病例分为化疗有效组和无效组，分析两组肿瘤化疗早期不同监测时间点ADC值的变化差异。结果化疗有效组从治疗后第9天开始ADC值明显升高，第13天、第15天肿瘤ADC值继续升高，无效组无明显升高，两组间ADC值比较差异有统计学意义。而两组患者化疗后第15天肿瘤直径均无明显变化。结论淋巴瘤化疗后肿瘤ADC值变化早于其形态学的改变，应用DWI技术监测肿瘤ADC值变化可作为早期评估淋巴瘤疗效的有效手段。
목적：탐토응용MR확산가권성상（ DWI）기술감측종류ADC치변화대조기평개림파류화료료효적개치。방법수집38례경병리검사증실적림파류환자，분별우화료전、화료후반개월（제1、3、5、9、13、15천）급화료결속시（약30천검사），접수DWI소묘병측량ADC치；동시재화료전、화료후제15천、화료결속시삼개시간점증가횡축위T1 WI급T2 WI소묘이측량종류적최대직경（장경）。안RESIST표준근거종류화료전、화료결속시최대직경변화정황장연구병례분위화료유효조화무효조，분석량조종류화료조기불동감측시간점ADC치적변화차이。결과화료유효조종치료후제9천개시ADC치명현승고，제13천、제15천종류ADC치계속승고，무효조무명현승고，량조간ADC치비교차이유통계학의의。이량조환자화료후제15천종류직경균무명현변화。결론림파류화료후종류ADC치변화조우기형태학적개변，응용DWI기술감측종류ADC치변화가작위조기평고림파류료효적유효수단。
Objective To study the value of MR diffusion-weighted imaging( DWI) in monitoring change of ADC value in the early evaluation of efficacy of lymphoma treated with chemotherapy.Methods 38 cases of lymphoma patients confirmed by pathology received DWI and ADC value were measured before chemotherapy,half month after the beginning of chemotherapy(1, 3,5,9,13,15 d) and at the end of chemotherapy(30 d).Before chemotherapy,15 d after the beginning of chemotherapy and at the end of chemotherapy,horizontal T1 WI and T2 WI scan were conducted to measure the maximum tumor diameter.According to the maximum tumor diameter by RESIST standard before chemotherapy and at the end of chemotherapy,the patients were divided into chemotherapy effective group and chemotherapy ineffective group.The changes of ADC value at different monitoring points in the early treatment of chemotherapy were analyzed.Results In the chemotherapy effective group, ADC value significantly in-creased 9 d after the beginning of chemotherapy,13 d ,15 d after the beginning of chemotherapy ADC value kept increasing.ADC value of the chemotherapy ineffective group had no significant increase.There had significant difference in ADC value between the 2 groups.15 d after the beginning of chemotherapy,the maximum tumor diameter of 38 cases had no significant change.Conclu-sion The change of ADC value are earlier than morphological changes in lymphoma treated with chemotherapy.DWI in monito-ring changes of ADC value can be effective measurement in the early evaluation of efficacy of lymphoma.