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中国癌症防治杂志

中国癌症防治杂志 ›› 2016, Vol. 8 ›› Issue (5): 295-298.doi: 10.3969/j.issn.1674-5671.2016.05.07

• 临床研究 • 上一篇    下一篇

磁共振在评价局部中晚期子宫颈癌放疗联合介入治疗疗效中的价值

  

  1. 宁夏医科大学总医院肿瘤医院放疗科
  • 出版日期:2016-10-25 发布日期:2016-11-14

MRI for evaluating the effects of radiotherapy combined with other interventions on local advanced cervical cancer

  • Online:2016-10-25 Published:2016-11-14

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摘要：

目的 探讨磁共振在评价局部中晚期子宫颈癌放疗联合介入治疗疗效中的价值。方法 收集行介入治疗再行放疗的子宫颈癌患者29例，分别于介入治疗前、第1次、第2次、第3次放疗后行盆腔MRI常规序列扫描和MR弥散加权成像（diffusion-weighted imaging，DWI）检查，记录表观扩散系数（apparent diffusion coefficient，ADC）和肿瘤体积大小。完成介入治疗后，根据是否有效分为介入治疗有效组和介入治疗无效组，比较两组不同治疗时间段ADC值的变化。完成所有治疗后，比较不同ADC值变化幅度患者的生存情况。结果 所有患者均完成治疗计划，其中治疗有效20例，无效9例。常规MRI图像特征：子宫颈癌在T1W1图像上呈等或低信号，在T2W1多呈均匀或欠均匀稍高或高信号；DWI图像表现：病灶呈不均匀高信号，边界显示清晰，ADC图像上呈不均匀低信号。第1次、第2次、第3次放疗后，介入治疗有效组ADC值均显著高于介入治疗无效组（P＜0.05）。ADC值变化幅度≥35%组的生存时间显著长于ADC值变化幅度＜35%组（P=0.021）。结论 MRI、DWI检查及ADC值可用于子宫颈癌放疗联合介入治疗后的疗效评估，为临床疗效和预后判断提供参考。

关键词: 子宫肿瘤, 子宫颈癌, 磁共振成像, 疗效评价

Abstract:

Objective To assess the usefulness of MRI for evaluating radiotherapy combined with other interventions to treat local advanced cervical cancer. Methods A total of 29 patients with cervical cancer were treated with radiotherapy and other interventions. All patients underwent conventional-sequence pelvic MRI scanning and diffusion-weighted MR imaging before intervention and after the first，second and third rounds of radiotherapy. Apparent diffusion coefficient （ADC） and tumor size were determined. Based on the effects of the intervention，the patients were classified as responders or non-responders. Changes in ADC were compared between the two groups，and survival time was compared among patients with different ADC values. Results Of the 29 treated patients，20 responded and 9 did not. Conventional MRI imaging revealed low signal in T1W1 images and higher，more homogeneous signal in T2W1 images. DWI images revealed heterogeneous high signal and clear lesion borders；ADC images revealed uneven lesions of low signal. ADC values after each radiotherapy round were significantly higher in responders than in non-responders（P<0.05）. Survival time was significantly longer in patients whose ADC changed by more than 35% than in those whose ADC changed by less than 35%（P=0.021）. Conclusion MRI，DWI and ADC values can be used to assess the effect of combined radiotherapy and other interventions to treat cervical cancer.

Key words: Uterine neoplasms, Cervical cancer, Magnetic resonance imaging, Efficacy evaluation