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Quantitative analysis of diffusion-weighted imaging and signal-to-noise ratio on the efficacy of albendazole liposome in the treatment of cerebral alveolar echinococcosis

OBJECTIVE: To investigate the feasibility of diffusion-weighted imaging (DWI) and signal-to-noise ratio (SNR) of lesions in evaluating the efficacy of albendazole liposomes in the treatment of cerebral alveolar echinococcosis (CAE). MATERIALS AND METHODS: Sixteen patients with CAE who met the inclusion criteria from April 2017 to December 2020 were enrolled. All patients underwent routine magnetic resonance sequence examination and DWI examination. The b-value were 1000 s/mm2 and 3000 s/mm2. The apparent diffusion coefficient (ADC) value and SNR of lesions before and after treatment were compared. The data of each group were statistically analyzed by Wilcoxon signed-rank sum test. RESULTS: After 1 year of treatment with albendazole liposomes, the SNR of lesions on T2WI sequence increased. There was a significant difference between the SNR of the same lesion before and after follow-up (P < 0.05). The ADC values of lesion parenchyma and edema area before and after treatment were compared. The difference between them was statistically significant in the both b values (ADC of parenchyma, P < 0.05; ADC of edema area, P < 0.001). Through binary linear classification, it was found that under the same b value, the effect of drugs on the edema area was more obvious than that on the parenchyma area; under different b values, the higher the b value, the higher the ability to evaluate the curative effect of drug therapy. CONCLUSION: Albendazole liposome is effective in the treatment of CAE, and long-term imaging follow-up of patients with CAE treated with albendazole liposome is necessary. When the change in conventional images is inapparent, the quantitative analysis of ADC value and SNR of lesions on T2WI can provide an objective basis for the evaluation of the curative effect of drug treatment in CAE.