ROI和ADC值标准差在预测鼻咽癌近期疗效中的相关分析

李  伟; 汤日杰; 彭俊琴; 李建生

中国临床医学影像杂志 ›› 2017, Vol. 28 ›› Issue (2) : 85-88.

李伟，汤日杰，彭俊琴，李建生

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The analysis of ADC value’s standard deviation and ROI for prediction the short-term#br# therapeutic effect in nasopharyngeal carcinoma

LI Wei, TANG Ri-jie, PENG Jun-qin, LI Jian-sheng

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摘要

目的：通过对比不同ROI所获得ADC值参数与鼻咽癌放疗联合新辅助化疗的近期疗效间的关系，明确具有最大预测价值的ADC值参数。方法：53例鼻咽癌在治疗前行MR扩散加权成像检查。通过A法（以肿瘤灶体积最大层的整个肿瘤灶边界划ROI）获得4个ADC值参数（ADC1-min、ADC1-mean、ADC1-max、ADC1-sd），通过B法（在肿瘤实性区划直径约2～3 mm2的ROI）获得3个ADC值参数（ADC2-min、ADC2-mean、ADC2-max）。在治疗后按照肿瘤灶体积变化情况分为敏感组和抗拒组。分析7种ADC值参数与分组的关系，通过ROC曲线的Az值寻找最佳参数，并分析它的相关影响因素。结果：53例患者归于敏感组35例，抗拒组18例。二组在ADC1-mean（0.875±0.114、0.962±0.116）×10-3 mm2/s、ADC1-sd（0.336±0.075、0.436±0.066）×10-3 mm2/s、ADC2-min（0.623±0.124、0.548±0.077）×10-3 mm2/s、ADC2-max（1.234±0.148、1.320±0.131）×10-3 mm2/s存在显著性差异（t=2.618、4.809、2.337、2.093，P=0.012、0.000、0.023、0.041）。二组在ADC1-min（0.554±0.088、0.512±0.084）×10-3 mm2/s、ADC1-max（1.512±0.214、1.630±0.215）×10-3 mm2/s、ADC2-mean（0.856±0.092、0.877±0.083）×10-3 mm2/s、不存在显著性差异（t=1.665、1.914、0.801，P=0.102、0.061、0.427）。ADC1-mean、ADC1-sd、ADC2-min、ADC2-max的Az值分别为0.725、0.864、0.676、0.662。ADC1-sd与年龄、性别、病理类型不存在显著性相关性。ADC1-sd与T分期（T1～T4，（0.263±0.102、0.342±0.081、0.394±0.062、0.404±0.096）× 10-3 mm2/s）存在明显正相关（F=4.425，P=0.008）。结论：以鼻咽癌整体肿瘤范围获得的ADC值标准差与T分期密切相关，对于预测近期放化疗效果具有更大的诊断价值。

Abstract

Objective: To identify the optimal ADC value parameter by evaluating the relationship between different ADC values by ROI and the short-term therapeutic effect of chemoradiation in nasopharyngeal carcinoma. Methods: Fifty-three cases of nasopharyngeal carcinoma patients were performed MR diffusion weighted imaging with b value(0, 800) s/mm2. To obtain 4 ADC value parameters(ADC1-min, ADC1-mean, ADC1-max, ADC1-sd) by A setting(ROI including the entire tumor foci) and obtain 3 ADC value parameters(ADC2-min, ADC2-mean, ADC2-max) by B setting(ROI with 2～3 mm diameter in tumor solid portion). Fifty-three cases were divided into the sensitive group and resistant group according to the size of the primary nasopharyngeal carcinoma after radiotherapy combined with neoadjuvant chemotherapy. To analyze the relationship between 7 parameters and find the best parameter through the Az value of ROC curve and its related factors. Results: Fifty-three cases were attributed to the sensitive group in 35 cases and the resistant group in 18 cases. There were significant difference(t=2.618, 4.809, 2.337, 2.093; P=0.012, 0.000, 0.023, 0.041) among ADC1-mean((0.875±0.114, 0.962±0.116)×10-3 mm2/s), ADC1-sd((0.336±0.075, 0.436±0.066)×10-3 mm2/s), ADC2-min((0.623±0.124, 0.548±0.077)×10-3 mm2/s), ADC2-max((1.234±0.148, 1.320±0.131)×10-3 mm2/s) in two group. And no significant difference(t=1.665, 1.914, 0.801; P=0.102, 0.061, 0.427) in ADC1-min((0.554±0.088, 0.512±0.084)×10-3 mm2/s), ADC1-max((1.512±0.214, 1.630±0.215)×10-3 mm2/s), ADC2-mean((0.856±0.092, 0.877±0.083)×10-3 mm2/s). The Az values of ADC1-mean, ADC1-sd, ADC2-min and ADC2-max were 0.725, 0.864, 0.676, 0.662. There was significant positive correlation(F=4.425, P=0.008) between ADC1-sd and T stage(T1～T4, (0.263±0.102, 0.342±0.081, 0.394±0.062, 0.404±0.096）×10-3 mm2/s), and no significant correlation between ADC1-sd and age, sex and pathological type. Conclusion: The standard deviation of ADC value obtained from ROI including whole nasopharyngeal carcinoma primary tumor has a greater value for predicting the short-term therapeutic effect, which is closely related to the T staging.

导出引用

李伟，汤日杰，彭俊琴，李建生. ROI和ADC值标准差在预测鼻咽癌近期疗效中的相关分析[J]. 中国临床医学影像杂志. 2017, 28(2): 85-88

LI Wei, TANG Ri-jie, PENG Jun-qin, LI Jian-sheng. The analysis of ADC value’s standard deviation and ROI for prediction the short-term#br# therapeutic effect in nasopharyngeal carcinoma[J]. Journal of China Clinic Medical Imaging. 2017, 28(2): 85-88

中图分类号： Ｒ739.62 Ｒ739.63 Ｒ445.2

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