肺癌靶向治疗后脑膜转移的3D FLAIR增强扫描研究
3D FLAIR Enhanced Scanning of Meningeal Metastases Following Targeted Therapy for Lung Cancer
王丽 1韦敏 2贺雪平 1李燕花 1杨万群 3刘红军 3黄飚3
作者信息
- 1. 511400 广州市番禺区中心医院放射科,番禺区医学影像研究所
- 2. 528400 中山火炬开发区人民医院
- 3. 510000 广东省人民医院放射科
- 折叠
摘要
目的 评价Cube FLAIR T2 WI增强扫描序列对非小细胞肺癌(NSCLC)患者经EGFR-TKIs治疗后出现脑膜转移(LM)的早期识别价值.方法 搜集经病理明确诊断肺癌且经过靶向药治疗后出现LM患者23 例,均进行增强T1 WI、矢状面Cube T1 WI与矢状面Cube FLAIR T2 WI增强扫描.所获得扫描图像由2 名MRI诊断医师分别盲法阅片分析,评价内容包括脑膜是否强化、LM部位(包括幕上脑浅表区、幕下小脑脑干区及全脑区)、图像质量评价.结果 23 例均成功进行增强T1 WI、矢状面Cube T1 WI与矢状面Cube FLAIR T2 WI增强扫描,获得的图像可用于质量评估.增强T1 WI与增强Cube T1 WI相比有2 例位于浅表区的病变未检测出(χ2 =27.74,P =0.02),增强T1 WI与增强Cube FLAIR T2 WI相比有1 例位于浅表区的病变未检测出,1 例全脑病变未检测出(χ2 =26.56,P = 0.01).增强T1 WI图像的CR低于增强Cube T1 WI图像(t =-0.44,P<0.05),增强T1 WI图像的CNR等于增强Cube T1 WI图像(t =-2.49,P<0.05).增强T1 WI图像的CR低于增强Cube FLAIR T2 WI图像(t =-0.15,P<0.05).增强Cube T1 WI图像的CR低于增强Cube FLAIR T2 WI图像(t =-0.26,P<0.05).增强T1 WI图像质量1例评2 分,20 例评3 分,2 例评4 分;Cube T1 WI图像质量 4 例评 3 分,19 例评 4 分(t值=1.38,P =0.03);增强Cube FLAIR T2 WI序列图像质量4 例评3 分,19 例评4 分(t值=1.26,P =0.02).结论 增强Cube FLAIR T2 WI图像作为容积扫描,分辨力高,对NSCLC EGFR +患者经EGFR-TKIs治疗后新发LM具有价高的敏感度,为肺癌患者靶向治疗的随访观察及个体化治疗方案提供依据.
Abstract
Objective To evaluate Cube FLAIR enhanced T2 WI scanning sequences for early and accurate identifica-tion of patients with non-small cell lung cancer(NSCLC)after EGFR-TKIs.Methods 23 patients with lung cancer diag-nosed pathologically and with LM after targeted drug therapy were examined by enhanced T1 WI,sagittal Cube T1 WI and sagittal Cube FLAIR T2 WI.The scanned images obtained were analyzed by two MRI diagnostic physicians who analyze the images in a blind way,respectively.The evaluation contents included enhancement or not,lesion site(including supraten-torial superficial brain area,subtentorial cerebellar brainstem area and whole brain area),and image quality evaluation(qualitative evaluation and quantitative evaluation).Results Enhanced T1 WI,sagittal Cube T1 WI and sagittal Cube FLAIR T2 WI were successfully performed in all 23 cases.The images obtained could be used for quality evaluation.Com-pared with enhanced Cube T1 WI,2 cases of superficial lesions were not detected(χ2 =27.74,P =0.02),compared with enhanced Cube FLAIR T2 WI,1 case of superficial lesion was not detected,and1 case of whole brain lesion was not detected(χ2 =26.56,P =0.01).CR of the enhanced T1 WI image was lower than that of the enhanced Cube T1 WI image(t =-0.44,P<0.05),and CNR of the enhanced T1 WI image was equal to that of the enhanced Cube T1 WI image(t =-2.49,P<0.05).CR in enhanced T1 WI images was lower than that in enhanced Cube FLAIR T2 WI images(t =-0.15,P<0.05).CR in enhanced Cube T1WI images was lower than that in enhanced Cube FLAIR T2WI images(t =-0.26,P<0.05).The image quality of enhanced T1 WI was 2 points in 1 case,3 points in 20 cases and 4 points in 2 ca-ses.Cube T1WI image quality was rated 3 points in 4 cases and 4 points in 19 cases(T-value =1.38,P =0.03).En-hanced Cube FLAIR T2WI sequence image quality was 3 points in 4 cases and 4 points in 19 cases(T-value =1.26,P = 0.02).Conclusion Enhanced Cube FLAIR T2 WI images,as volume scanning,have high resolution,and are highly sensi-tive to new LMS in NSCLC patients treated with EGFR + after EGFR-TKIs,providing evidence for follow-up observation and individualized treatment of lung cancer patients with targeted therapy.
关键词
非小细胞癌/EGFR-TKIs/脑膜转移/3D/FLAIR增强Key words
NSCLC/EGFR-TKIs/Leptomeningeal metastasis/3D FLAIR enhancement引用本文复制引用
基金项目
国家自然科学基金面上项目(82071871)
出版年
2024
NETL
NSTL
万方数据