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目的探讨MR扩散加权成像(DWI)在膀胱癌经髂内动脉灌注化疗及栓塞术后疗效评价中的作用。资料与方法对经病理证实的28例膀胱移行上皮细胞癌患者于介入术前后行MR DWI。在GE Signa Excite HD 1.5TMR扫描仪上,先取多个扩散敏感梯度因子(b值)分别为300 s/mm2、500 s/mm2、800 s/mm2、1000 s/mm2、1200 s/mm2、1500 s/mm2,利用固定参数组合的自旋回波-回波平面成像(SE-EPI)序列对28例经动脉灌注化疗及栓塞术的膀胱癌肿块分别于术前24～48 h、术后7～10天各进行一次多b值的DWI。经分析比较后选取合适的b值为1200s/mm2,测量出每例膀胱癌不同监测时间点的肿瘤平均表观扩散系数(ADC)值,对两组结果进行比较。结果 28例膀胱肿瘤治疗前平均ADC值(1.15±0.12)×10-3mm2/s,介入治疗后肿瘤平均ADC值(1.36±0.15)×10-3mm2/s,治疗后肿瘤平均ADC值升高,P值<0.05,差异具有统计学意义。结论初步研究表明,对膀胱肿瘤的ADC值进行动态测定,可以评价膀胱癌介入治疗后早期病理学反应。
Objective To investigate the role of MR diffusion weighted imaging (DWI) in evaluating the curative effect of bladder cancer after intra-iliac artery chemotherapy and embolization. Materials and Methods MR DWI was performed in 28 patients with pathologically confirmed bladder transitional cell carcinoma before and after intervention. On a GE Signa Excite HD 1.5 TMR scanner, multiple diffusion-sensitive gradient factors (b values) were taken as 300 s / mm2,500 s / mm2,800 s / mm2,1000 s / mm2,1200 s / mm2,1500 s / mm2. Twenty-eight cases of bladder cancer treated with intra-arterial chemoembolization and embolization were treated with fixed echo-echo planar imaging (SE-EPI) Multi-b DWI was performed for 10 days each. After analysis and comparison, we selected the appropriate b value of 1200s / mm2, measured the average apparent diffusion coefficient (ADC) value of each tumor at different monitoring time points, and compared the results of the two groups. Results The average ADC value (1.15 ± 0.12) × 10-3mm2 / s before treatment in 28 cases of bladder cancer and the average ADC value (1.36 ± 0.15) × 10-3mm2 / s in the interventional treatment group, mean ADC value increased after treatment, P value <0.05, the difference was statistically significant. Conclusion Preliminary studies have shown that the ADC value of bladder cancer can be dynamically measured to evaluate the early pathological response of bladder cancer after interventional therapy.