1.5T MRI高分辨率成像及动态增强参数在食管癌精准放疗中的价值研究-现代医学

1.5T MRI高分辨率成像及动态增强参数在食管癌精准放疗中的价值研究

单位：海安市中医院放射科, 江苏南通 226600

分类号：R735.1

出版年·卷·期（页码）：2023·51·第十期（1410-1416）

摘要：

目的：研究1.5T磁共振成像（MRI）高分辨率成像及动态增强参数在食管癌精准放疗中的价值。方法：回顾性分析2017年5月至2022年1月海安市中医院收治的144例食管癌患者，根据病灶类型不同分为对照组（n=65，圆周性病灶）与研究组（n=79，偏心性病灶），对照组根据放疗疗效分为有效组1（n=38）和无效组（n=27），研究组根据放疗疗效分为有效组2（n=43）和无效组2（n=36）。所有患者均接受三维适形放疗，并进行1.5T MRI高分辨率成像及动态增强参数检查，记录血管外细胞外容积分数（V_e）、回流速率常数（K_ep）、容积转移常数（K^trans）、表观弥散系数（ADC）。结果：有效组1 Δ1V_e、Δ1K_ep、Δ1K^trans低于无效组1（P<0.05），而Δ1ADC更高（P<0.05）；有效组2 Δ2V_e、Δ2K_ep、Δ2K^trans低于无效组2（P<0.05），而Δ2ADC更高（P<0.05）；复发组1 Δ3V_e、Δ3K_ep、Δ3K^trans高于非复发组1（P<0.05），而Δ3ADC更低（P<0.05）；复发组2 Δ4V_e、Δ4K_ep、Δ4K^trans高于非复发组2（P<0.05），而Δ4ADC更低（P<0.05）。结论：1.5T MRI高分辨率成像可用于诊断食管癌T分期，动态增强参数（V_e、K_ep、K^trans、ADC）变化情况与食管癌精准放疗患者疗效及预后密切相关。

Objective: To investigate the value of 1.5T magnetic resonance imaging(MRI) high-resolution imaging and dynamic enhancement parameters in precision radiotherapy for esophageal cancer. Methods: A retrospective analysis was conducted on 144 esophageal cancer patients admitted to the Hai'an Hospital of Traditional Chinese Medicine from May 2017 to January 2022. Based on different lesion types, they were divided into the control group(n=65, circumferential lesions) and the study group(n=79, eccentric lesions). The control group was divided into effective group 1(n=38) and ineffective group 1(n=27) according to the radiotherapy efficacy, and the study group was divided into effective group 2(n=43) and ineffective group 2(n=36) according to the radiotherapy efficacy. All patients underwent three-dimensional conformal radiotherapy and received 1.5T MRI high-resolution imaging and dynamic enhancement parameter examinations. Parameters including extracellular extracellular volume fraction(V_e), reflux rate constant(K_ep), volume transfer constant(K^trans), and apparent dispersion coefficient(ADC) were recorded. Results: In the effective group 1,Δ1V_e,Δ1K_ep,Δ1K^trans were lower than in the ineffective group 1(P<0.05), while the Δ1ADC was higher(P<0.05). In the effective group 2,Δ2V_e,Δ2K_ep, Δ2K^trans were lower than in the ineffective group 2(P<0.05), while the Δ2ADC was higher(P<0.05). In the recurrence group 1,Δ3V_e,Δ3K_ep, Δ3K^trans were higher than in the non-recurrence group 1(P<0.05), while the Δ3ADC was lower(P<0.05). In the recurrence group 2,Δ4V_e, Δ4K_ep, Δ4K^trans were higher than in the non-recurrence group 2(P<0.05), while the Δ4ADC was lower(P<0.05). Conclusion: 1.5T MRI high-resolution imaging can be used to diagnose the T stage of esophageal cancer, and dynamic enhancement parameters(V_e, K_ep, K^trans, ADC) changes are closely related to the therapeutic efficacy and prognosis of precision radiotherapy for esophageal cancer patients.

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