摘要
目的探讨放疗前弥散加权成像(Diffusion Weighted Imaging,DWI)预测非小细胞肺癌放射性肺炎的效果及放疗后表观弥散系数(Apparent Diffusion Coefficient,ADC)值变化。方法选择2019年2月至2021年2月我院收治的120例Ⅲ、Ⅳ期非小细胞肺癌患者的临床资料,根据放疗后患者是否出现放射性肺炎分为RP组(n=35)和Non-RP组(n=85)。比较两组患者的一般资料、放疗前DWI的ADC数值资料和放疗后ADC数值资料;通过随机行走模型来评价两组患者ADC的改变。结果两组患者放疗前的平均ADC1值、ADC_(max)值和ADC_(min)值差异均具有统计学意义(P<0.05)。放疗前患者的平均ADC1值预测非小细胞肺癌放射性肺炎的曲线下面积为0.862(95%CI:0.761~0.934,P<0.01),敏感度为95.17%,特异性为77.65%,以1.42×10^(-3)mm^(2)/s为最佳截点。放疗后,120例非小细胞肺癌患者的ADC值均有升高,两组平均ADC2值、放疗后1周ΔADC_(1)值、放疗后4周ΔADC_(2)值、放疗后8周ΔADC_(3)值和放疗后6个月ΔADC_(4)值差异有统计学意义(P<0.05),且Non-RP组在放疗前后ADC值变化较RP组更为显著。随机行走模型结果显示,Non-RP组对患者上述指标的改善效果较好。结论放疗前Ⅲ、Ⅳ期非小细胞肺癌患者DWI揭示了非小细胞肺癌放疗后ADC值较放疗前明显升高,且未发生放射性肺炎患者的ADC值升高趋势更为显著。
Objective To explore the prediction of radiation pneumonia in non-small cell lung cancer by diffusion weighted imaging(DWI)before radiotherapy and the change of apparent diffusion coefficient(ADC)after radiotherapy.Methods The clinical data of 120 patients with stage Ⅲ and Ⅳ non-small cell lung cancer treated in our hospital from February 2019 to February 2021 were retrospectively selected.According to the occurrence of radiation pneumonia after radiotherapy,the patients were divided into RP group(n=35)and Non-RP group(n=85).The general data,ADC data of DWI before radiotherapy and ADC data of DWI after radiotherapy were compared with groups,and the changes of ADC in the two groups were evaluated by random walk model.Results There were differences in average ADC1 value,ADC_(max) and ADC_(min) values between the two groups before radiotherapy(P<0.05).The average ADC1 value of patients before radiotherapy predicted the area under curve of radiation pneumonia of nonsmall cell lung cancer was 0.862(95%CI:0.761~0.934,P<0.01),the sensitivity was 95.17%,the specificity was 77.65%,and the best cut-off point was 1.42×10^(-3) mm^(2)/s.The ADC values were increased in all patients after radiotherapy.There were significant differences in average ADC2 value,ΔADC_(1) value at 1 week,ΔADC_(2) value at 4 week,ΔADC_(3) value at 8 week and ΔADC_(4) value at 6 months after radiotherapy between the two groups.The change of ADC before and after radiotherapy in Non-RP group was more significant than that in RP group.The results of random walk model showed that Non-RP group had a better effect on the improvement of the above-mentioned indexes.Conclusion DWI in patients with stage Ⅲ and Ⅳ non-small cell lung cancer before radiotherapy revealed that the ADC value of patients with non-small cell lung cancer after radiotherapy was significantly higher than that before radiotherapy,and the ADC value of patients without radiation pneumonia was more significant.
作者
杨宝龙
边燕
郭东栋
YANG Baolong;BIAN Yan;GUO Dongdong(Department of Oncology,Yan’an People’s Hospital,Yan’an Shaanxi 716000,China;Department of Obstetrics,Yan’an University Affiliated Hospital,Yan’an Shaanxi 716000,China)
出处
《中国医疗设备》
2023年第4期149-154,165,共7页
China Medical Devices
基金
延安市科技计划(2021YF-13)。
关键词
磁共振弥散加权成像
非小细胞肺癌
放射性肺炎
表观弥散系数
放疗
diffusion weighted imaging
non-small cell lung cancer
radiation pneumonia
apparent diffusion coefficient
radiotherapy
