中国医学科学院学报2018，Vol.40Issue(2)：256-263,8.DOI:10.3881/j.issn.1000-503X.2018.02.017
动态对比增强磁共振渗透性参数早期监测肝转移瘤贝伐单抗联合常规化疗治疗敏感性的价值
Dynamic Contrast-enhanced Magnetic Resonance Imaging Permeability Parameters Monitor the Early Response to Bevacizumab Plus Chemotherapy in Colorectal Cancer Patients with Liver Metastases
摘要
Abstract
Objective To investigate the value of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) permeability parameters in monitoring the early response to bevacizumab plus chemotherapy in colorectal cancer patients with liver metastases.Methods Magnetic resonance examinations including plain and DCE-MRI were performed in 28 colorectal cancer patients with liver metastases.The permeability parameters including the volume transfer constant (Kt),extravascular extracellular volume fraction (Ve),reverse volume transfer constant (Kep),and percentage of plasma volume (Vp) were measured before chemotherapy and at the first chemotherapy cycle.All the target lesions were grouped into the hypersensitivity and hyposensitivity groups,and t test was used to calculate the statistical significance between these two groups.The receiver operating characteristic (ROC) curve analysis was also performed for evaluating the diagnostic efficacy in monitoring the early response to chemotherapy.Results Totally 64 target lesions,including 29 lesions in the hypersensitivity group and 35 lesions in the hyposensitivity group,were confirmed.The Ktrans0 and Kep0 values of the hypersensitivity group were significantly higher than those of the hyposensitivity group before chemotherapy (P =0.040,P =0.049),whereas the Ve0 and Vp0 values showed no statistically significant difference (P ＞ 0.05).The Ktrans1 and Kep1 values of the hypersensitivity group were significantly lower at the first chemotherapy cycle than the Ktrans0 and Kep0 values before chemotherapy (P =0.017,P =0.031),and the Ve1 and Vp1 values showed no significant change between these two groups (P ＞ 0.05).When the Ktrans0 value was 0.149 min-1 the area under curve was 0.782,the sensitivity was 89.7％,and the specificity was 62.9％.When the Kep0 value was 1.129 min-1,the area under curve was 0.726,the sensitivity was 65.5％,and the specificity was 71.4％.Conclusion The DCE-MRI permeability parameters is useful for monitoring the early response to chemotherapy,and the Ktrans value can be a quantitative indicator to predict early response.关键词
磁共振/渗透性/肝脏转移瘤/化疗Key words
magnetic resonance imaging/permeability/liver metastatic tumor/chemotherapy分类
医药卫生引用本文复制引用
刘东,钱海峰..动态对比增强磁共振渗透性参数早期监测肝转移瘤贝伐单抗联合常规化疗治疗敏感性的价值[J].中国医学科学院学报,2018,40(2):256-263,8.基金项目
浙江省医药卫生科技计划一般项目(2015KYB377)Supported by Zhejiang Medical Science and Technology Foundation (2015KYB377) （2015KYB377）
