| Objective: To explore the value of 3.0T MR diffusion weighted imaging(DWI)in evaluating the early curative effect of chemotherapy in patients with advanced pancreatic cancer.Material and Methods: 31 patients(19 males and 12 females,aged 45-87 years old,mean age 66.21 ± 11.14 years old)with pathologically confirmed pancreatic ductal adenocarcinoma were retrospectively analyzed from August 2014 to September 2017.The GE 3.0T DISCOVERY 750 W Superconducting magnetic resonance apparatus was used to perform MRI conventional(T1WI,T2WI)and DWI(b = 0,b = 800)within 2 weeks before treatment,after one course of conventional chemotherapy(1 month)and six months.The changes of size,signal and apparent diffusion coefficient(apparent diffusion coefficient,ADC)before and 1 months and 6 months after the treatment of the lesion were observed.The size of tumor at 6 months after treatment was observed,and all cases were divided into progressive group and stable group according to RECIST standard.The changes of ADC value between the two groups and the two groups before and after 1 months were compared,and the relationship between ADC value and the survival time of patients was analyzed.Results:(1)The ADC value in the progressive group(14 cases)was(1.31±0.18)×10-3mm2/s before treatment,and was(1.31 ±0.14)×10-3mm2/s after treatment,which was no statistically significant(t=0.15,P=0.883).The stable group(17 cases)before treatment(1.35 ±0.08)×10-3mm2/s,after treatment ADC value(1.45±0.09)×10-3mm2/s,higher than that before treatment,there were significant differences(t=4.52,P=0.000);Before and after treatment,the progressive group △ ADC was significantly lower than that of the stable group,and there was a significant difference between the two groups(t=-3.52,P=0.001).(2)The size of tumor cases in the progressive group before treatment,and after treatment in a month and six months was(4.56±1.88)cm,(4.55±1.89)cm and(5.45±2.09)cm respectively.There was no statistical difference between before and after 1 months treatment(t=0.44,P=0.668).While there was statistical difference between before and after treatment in six months.(t=7.56,P=0.000).The tumor size in the stable group before treatment,one month after treatment,and six months after treatment were(4.81±2.12)cm,(4.81±2.13)cm,(4.79±2.18)cm.There was no significant difference between before treatment and after treatment,before treatment and 6 months(t=1.00,P=0.336;t=0.31,P=0.764).(3)The 6 month and 1 year survival rates in the progress group were 35.5% and 6.5% respectively;in the stable group 6 months and 1 year survival rates were 45.2% and 25.8%,Survival was statistically significant(χ2= 4.973,P = 0.026).The 6-month and 1 year survival rates of high ADC group before treatment(15 cases)were 36.8% and 15.8% respectively;The low ADC value group(16 cases)6-month and 1 year survival rate were 36.8% and 10.5% respectively.There was no significant difference in survival between the two groups(χ2 = 0.058,P = 0.809);At 1 month after treatment,the 6-month and 1 year survival rates of high ADC value group(15 cases)were 41.9% and 25.8% respectively;The low ADC value group(16 cases)6-month and 1 year survival rate were 38.7% and 6.5%,There was a significant difference(χ2 = 7.618,P = 0.006).The 6 months and 1 year survival rates of the high △ ADC group(15 cases)were 36.8% and 21.1%,respectively.The corresponding survival rates of the low △ ADC group(16 cases)were 36.8% and 5.3%,respectively.There was no statistical difference in survival between the two groups(χ2= 4.524,P = 0.112).Conculsion:(1)The early ADC value after chemotherapy can be used as a predictor of the early efficacy of advanced pancreatic cancer,and the size of the early tumor can not be used as an indicator to evaluate the efficacy of the tumor;(2)There was a correlation between early changes in ADC values and survival rates. |
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