目的探讨磁共振弥散加权成像 (MRI-DWI)表观弥散系数(ADC值)和磁共振 动态对比增强(MRI-DCE)参数对放化疗同 步治疗食管癌患者疗效及预后的临床评 估价值。方法 选择我院收治的食管癌患 者70例，均进行放化疗，记录放化疗效 果，并于放化疗前后进行MRI-DWI和MRIDCE检查，获取MRI-DWI扫描ADC值和MRIDCE扫描定量参数[容量转移常数(Ktrans)、 血管外细胞外间隙容积比(Ve)、速率常 数(Kep)]，比较不同疗效组以及不同预后 组相关参数值，并以ROC曲线评估相关参 数预测食管癌放化疗同步治疗效果。结 果 CR组放化疗前ADC值、Ktrans均大于PR 组(P<0.05)，Ve、Kep与PR组均无显著差异 (P>0.05)。ROC曲线分析显示，放化疗前 Ktrans=0.29/min为阈值，预测食管癌同步 放化疗疗效CR的曲线下面积、敏感度、 特异度分别为0.840、70.0%、81.5%；放 化疗前ADC值=1.59×10-3mm2 /s为阈值， 预测食管癌同步放化疗疗效CR的曲线下 面积、敏感度、特异度分别为0.811、 76.0%、76.0%。治疗后3年生存组ADC值、 Ktrans均大于治疗后3年死亡组(P<0.05）， Ve、Kep与治疗后3年死亡组均无显著差异 (P>0.05)。结论 MRI-DWI ADC值和MRIDCE Ktrans有助于评估放化疗同步治疗食管 癌患者疗效及预后。

Objective To explore the clinical value of the apparent diffusion coefficient (ADC) and dynamic-contrast enhancement (MRI-DCE) parameters of magnetic resonance diffusion-weighted imaging (MRI-DWI)in evaluating the curative effect and prognosis of patients with esophageal cancer treated with concurrent chemoradiotherapy. Methods Seventy patients with esophageal cancer admitted to the hospital during the period were selected. All of them underwent concurrent chemoradiotherapy and the effects were recorded. MRI-DWI and MRI-DCE were performed before and after chemoradiotherapy to obtain the ADC value of MRI-DWI scan and quantitative parameters of MRI-DCE scan [capacity transfer constant (Ktrans), extravascular extracellular space to volume ratio (Ve), rate constant (Kep)]. The relevant parameters were compared between groups with different curative effect and different prognosis. The ROC curve was used to evaluate the effects of relevant parameters in predicting the curative effect of concurrent chemoradiotherapy. Results The ADC value and Ktrans of CR group were higher than those of PR group (P<0.05), but there was no significant difference in Ve or Kep between the two groups (P>0.05). ROC curve analysis showed that Ktrans=0.29/min was the threshold before chemoradiotherapy. The area under the curve, sensitivity and specificity for predicting CR were 0.840, 70.0% and 81.5%. The threshold of ADC value before chemoradiotherapy was 1.59×10-3mm2 /s. The area under the curve, sensitivity and specificity for predicting CR were 0.811, 76.0% and 76.0%, respectively. The ADC value and Ktrans of the survival group were higher than those of the death group (P<0.05), but there was no significant difference in Ve or Kep(P>0.05). Conclusion The ADC value of MRI-DWI and Ktrans of MRI-DCE are helpful to evaluate the curative effect and prognosis of patients with esophageal cancer treated with concurrent chemoradiotherapy.