前瞻性探讨磁共振精确早期评价非小细胞肺癌氩氦刀治疗后残留或复发的价值。通过对50例非小细胞肺癌氩氦刀治疗后多个时间点（治疗后1天内、第7天、1个月、3个月、6个月，之后每隔半年复查一次）的磁共振图像分析，多序列观察病变残留及复发的早期征象，探讨确定性病变残留及复发的磁共振常规序列、DWI、新序列IVIM及时间-信号强度曲线各自的价值，以及确定IVIM得到的定量影像生物标志slow ADC、fast ADC和fraction of fast ADC判定非小细胞肺癌氩氦刀治疗后残留或复发的价值及参考值范围。对有活性部位及时利用粒子植入等手段补充治疗真正做到精确治疗，延长患者的无进展生存期。并进一步将其与KPS评分、无进展生存期、OS等进行相关性分析，进一步明确其早期预测确定疗效的价值。

To valuate the application of MRI in early accurately assessing residual tumor or recurrence of non-small cell lung cancer after cryosurgical treatment. To analyze the MR images of multiple time points, within 1 day after treatment, 7 days, 1 month, 3 months, 6 months, followed by a half-yearly review once, in 50 non-small cell lung cancer patients after the cryosurge, and to seek early signs of residual tumor or recurrence on multiple sequence. To explore the early features of the residual tumor or recurrence on conventional MR sequences, DWI, new IVIM and time-signal intensity curve, as well as quantitative imaging biomarkers of slow ADC, fast ADC and fraction of fast ADC acquaired by IVIM and define the reference range. Seed implantation and other means supplemental treatment were performed for truly accurate treatment to prolong progression-free survival. To further analyze the KPS score, the progression-free survival and OS, and determine the value of MRI in early accurately assessing residual tumor or recurrence of non-small cell lung cancer after cryosurgical treatment.

背景：探讨非小细胞肺癌(NSCLC)氩氦刀术后多个时间点消融区MRI表现及变化趋势，提高对消融区MRI影像学特点及其变化的认识。主要研究内容：收集2014年1月至2017年12月河南省肿瘤医院接受氩氦刀治疗的62例NSCLC患者，所有患者分别于治疗前、治疗后1天、1周、1个月、3个月、6个月和12个月进行胸部MR平扫和动态增强扫描。分析消融区最大径和信号强度随时间的变化趋势，同时绘制消融区动态增强时间-信号强度曲线并分类。重要结果：NSCLC氩氦刀术后MRI表现具有一定的特征性，术后1周消融区边缘低信号环是否完整有助于判断复发，术后1周至3个月是观察消融区发生较大改变的重要时间窗，MRI在识别消融区及动态反映其变化方面具有重要价值。关键数据及其科学意义：治疗后不同时间点典型MRI表现：术后1天消融区呈T1WI及T2WI高低混杂信号；术后1周表现为T1WI高、T2WI高信号并边缘低信号环；术后1个月呈T1WI高信号、T2WI高信号；术后3个月消融区范围明显缩小，T1WI及T2WI呈等信号；术后6和12个月，消融区大小和信号强度变化不大。术后1d消融区最大径最大并逐渐缩小，信号强度术后1周最大并逐渐下降至等信号。术后1 天~1个月消融区时间-信号曲线为无明确强化的直线型，术后3~12个月呈轻度延迟强化的流人型。随访周期内6例病灶复发,均发生在术后3个月，且术后1周消融区边缘低信号环不完整。