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目的:探讨弥散加权成像(diffusion-weighted imaging,DWI)在预测成胶质细胞瘤(glioblastoma,GBM)患者放化疗预后中的价值。方法:对GBM肉眼全切患者进行前瞻性研究。所有患者均接受标准放化疗。术后放疗前进行DWI检查,测量近瘤周区、中瘤周区和远瘤周区的表观弥散系数(apparent diffusion coefficient,ADC)值,分别按ADC平均值和ADC最小值的中位值进行分组,分析患者的总生存(overall survival,OS)和无进展生存(progression-free survival,PFS)情况。结果:共83例患者入组,6个月和12个月的OS率分别为99%和82%,6个月和12个月的PFS率分别为84%和66%。近瘤周区ADC平均值>0.979×10-3 mm2/s组的OS和PFS均长于ADC平均值≤0.979×10-3 mm2/s(P OS=0.019,P PFS=0.005);该区ADC最小值>0.894×10-3 mm2/s组的PFS长于ADC最小值≤0.894×10-3 mm2/s组(P=0.018)。在中瘤周区和远瘤周区,各组OS和PFS间的差异均无统计学意义(P值均>0.05)。结论:DWI对预测GBM患者的放化疗疗效有一定价值。
Objective: To investigate the value of diffusion-weighted imaging (DWI) in predicting the prognosis of patients with glioblastoma (GBM). METHODS: Prospective studies were performed on patients with GBM grossly resected. All patients received standard chemoradiation. DWI was performed before radiotherapy, and the apparent diffusion coefficient (ADC) values were measured in the peritumoral neoplasms, midnodular neoplasms and peritumoral neovascularization areas, respectively. The mean ADC values and median ADC values The patients were divided into groups and analyzed for overall survival (OS) and progression-free survival (PFS). Results: A total of 83 patients were enrolled in this study. The OS rates at 6 months and 12 months were 99% and 82%, respectively. The PFS rates at 6 and 12 months were 84% and 66%, respectively. The ADC and PFS of ADC in the peritumoral tumor area> 0.979 × 10-3 mm2 / s were all longer than those of the ADC (≤0.979 × 10-3 mm2 / s) (P OS = 0.019, P PFS = 0.005) PFS> 0.894 × 10-3 mm2 / s was longer than ADC minimum ≤0.894 × 10-3 mm2 / s (P = 0.018). There was no significant difference between OS and PFS in the peritumoral and perinatal regions (P> 0.05). Conclusion: DWI has some value in predicting the efficacy of radiotherapy and chemotherapy in patients with GBM.