| 裘 丽,丁忠祥,谢铁明.基于DWI磁共振成像技术测量食管癌原发灶ADC值观察者内与观察者间一致性的临床研究[J].肿瘤学杂志,2017,23(12):1074-1078. |
| 基于DWI磁共振成像技术测量食管癌原发灶ADC值观察者内与观察者间一致性的临床研究 |
| Reproducibility of ADC Value on DWI-MR in Measurement of Primary Tumors for Patients with Esophageal Cancer |
| 投稿时间：2017-06-03 |
| DOI：10.11735/j.issn.1671-170X.2017.12.B006 |
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| 中文关键词: 食管肿瘤 弥散加权成像 ADC 一致性 |
| 英文关键词:esophageal carcinoma diffused weighed imaging apparent diffused coefficient consistency |
| 基金项目:浙江省自然科学基金青年项目（LQ15H160001）；浙江省自然科学基金一般项目(LY17H16003)；浙江省卫生厅一般计划项目(2015KYB063，2015KYB048，2016KYA051) |
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| 中文摘要: |
| 摘 要：［目的］ 探讨食管癌瘤床区ADC值不同观察者及同一观察者间测量一致性，明确磁共振DWI技术在食管癌治疗中的价值。［方法］ 入组30例经病理明确食管癌患者，所有患者均接受根治性放疗。分别于放疗前及放疗至第5次分割时各行1次MRI+DWI检查，A、B两位观察者利用脱机分析软件根据既定方法于食管癌最大短径勾画感兴趣区域（ROI），得出相应ROI区域ADC值，每位观察者先后进行两次测量，两次测量间隔2周记忆洗脱期。测量得出治疗前及治疗期间ADC值分别标记为pre-ADC及intra-ADC，并应用Bland-Altman方法评价观察者间及观察者内测量一致性。［结果］ 治疗前观察者A两次测量所得pre-ADC平均值分别为1.25±0.22（10-3mm2/s）、1.27±0.23（10-3mm2/s），观察者B两次所得pre-ADC平均值分别为1.25±0.23（10-3mm2/s）、1.26±0.22（10-3mm2/s）。观察者A观察者内偏倚及一致性界限分别为-0.02 和-0.13~0.09，两位观察者间测量偏倚及一致性界限分别为0.01和-0.09~0.10。放疗至第5次分割时，观察者A两次测量所得pre-ADC平均值分别为1.57±0.32（10-3mm2/s）、1.59±0.30（10-3mm2/s），观察者B两次所得pre-ADC平均值分别为1.60±0.34（10-3mm2/s）、1.58±0.33（10-3mm2/s）。观察者A所得观察者内偏倚及一致性界限分别为-0.02 和-0.13~0.09，两位观察者间测量偏倚及一致性界限分别为0.03和-0.15~0.10。［结论］ 对于食管癌患者利用特定方法应用磁共振DWI测量食管癌ADC值能够获得较好的观察者内及观察者间一致性。 |
| 英文摘要: |
| Abstract：［Objective］ To evaluate the reproducibility of apparent diffusion coefficient (ADC) value on diffusion weighted imaging-MR (DWI-MR) in measurements of primary tumors of for patients with esophageal carcinoma. ［Methods］ Thirty patients diagnosed as esophageal carcinoma pathologically underwent radical radiotherapy. Esophageal DWI-MR examinations were performed before treatment and after 5th fraction radiotherapy (RT)，respectively. Two observers A and B independently and blindly measured ADC values of primary tumors using off-line software，and the ADCs of baseline and 5th RT were labeled as pre-ADC and intra-ADC，respectively. Inter- and intra-observer reproducibility of the measurements were assessed using the Bland-Altman method. ［Results］ Before the treatment the mean pre-ADCs of primary tumors were 1.25±0.22（10-3mm2/s） and 1.27±0.23（10-3mm2/s） in observer A for the measurement 1 and 2，and the bias and limits of agreement for the intra-observer measurements were -0.02 and -0.13~0.09；in observer B the mean pre-ADC of primary tumors were 1.25±0.23（10-3mm2/s） and 1.26±0.22（10-3mm2/s） for the measurement 1 and 2，and the bias and limits of agreement for the inter-observer measurements were 0.01 and -0.09~0.10. After the 5th RT，mean intra-ADC of primary tumors were 1.57±0.32（10-3mm2/s） and 1.59±0.30（10-3mm2/s） in observer A for the measurement 1 and 2，and the bias and limits of agreement for the intra-observer measurements were -0.02 and -0.13~0.09；in observer B，the mean intra-ADC of primary tumors were 1.60±0.34（10-3mm2/s） and 1.58±0.33（10-3mm2/s） for the measurement 1 and 2，and the bias and limits of agreement for the inter-observer measurements were 0.03 and -0.15~0.10.［Conclusion］ It may be sufficiently reproducible to measure the primary tumors of esophageal carcinoma between inter-observer and intra-observer using DWI examination according to stipulated rules. |
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