宫颈癌放疗后骨盆不全骨折的MRI表现

发布时间：2018-02-16 08:58

本文关键词： 宫颈癌放疗不全骨折磁共振成像　出处：《临床放射学杂志》2017年12期 　论文类型：期刊论文

【摘要】：目的分析女性宫颈癌放疗后骨盆不全骨折(PIF)的临床特征及MRI在PIF中诊断与鉴别诊断价值。方法搜集17例宫颈癌放疗后PIF患者的临床及影像学资料。所有患者均行放疗前盆腔MRI检查,放疗后每2~3个月进行盆腔MRI随访,发生PIF时4例同时行CT检查,4例同时行骨扫描及正电子发射体层摄影术/计算机断层扫描(PET/CT)。通过MRI观察患者放疗野内骶骨、髂骨、耻骨、脊椎骨折情况。结果 17例患者,从开始放疗至影像学上发现PIF的中位时间为14个月(6~36个月)。发生PIF部位共42处,其中14例同时有1处以上骨折。骨折部位分布于骶骨(27处)、耻骨(5处)、髂骨(6处)及第5腰椎(4处)。PIF在MRI T_1WI、T_2WI均表现为低信号的骨折线及伴随周围的骨髓水肿。结论放疗引起的PIF是女性宫颈癌患者放疗后常见的并发症,尤其是绝经后女性。MRI在显示早期骨折导致的骨髓水肿上有较高的敏感性,且能够显示周围软组织情况,在与骨转移的鉴别诊断上有一定的价值。
[Abstract]:Objective to analyze the clinical features of pelvic incomplete fracture after radiotherapy and the value of MRI in the diagnosis and differential diagnosis of PIF. Methods the clinical and imaging data of 17 patients with PIF after radiotherapy for cervical cancer were collected. Pelvic MRI before radiotherapy, Pelvic MRI was followed up every 2 ~ 3 months after radiotherapy. 4 cases underwent CT scan and positron emission tomography / computed tomography (CT) at the same time during PIF. MRI was used to observe the sacrum, iliac bone and pubic bone in the radiation field. Results the median time of PIF in 17 patients was from 14 months to 36 months from the beginning of radiotherapy to radiography. There were 42 sites of PIF. Among them, 14 cases had more than one fracture at the same time. The fracture sites were located in 27 sites of sacrum, 5 of pubis, 6 of ilium) and 4 of the fifth lumbar vertebrae. In MRI T1WII-T2WI, all of them showed low signal intensity fracture line and accompanying bone marrow edema. PIF caused by radiotherapy is a common complication in women with cervical cancer after radiotherapy. Especially in postmenopausal women, MRI has a high sensitivity in showing bone marrow edema caused by early fracture, and can show the surrounding soft tissue, which has certain value in the differential diagnosis of bone metastasis.
【作者单位】：上海交通大学医学院附属瑞金医院;
【分类号】：R445.2;R737.33

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