磁共振弥散加权成像在宫颈癌放疗疗效和预后评估中的应用价值

发布时间：2018-03-06 09:07

本文选题：宫颈癌　切入点：磁共振弥散加权成像　出处：《中国老年学杂志》2017年21期 　论文类型：期刊论文

【摘要】：目的探讨磁共振弥散加权成像(DWI)评估宫颈癌放疗疗效和预后的应用价值。方法选择在该院进行化疗的宫颈癌患者35例为观察组,另选择在该院接受盆腔磁共振成像(MRI)检查的非宫颈癌患者30例作为对照组。在治疗前后进行MRI、DWI检查,并将检查图像进行处理后,测量表观扩散系数(ADC)值,比较两组ADC值,分析不同病理类型、不同疗效患者的ADC差异。结果 DWI检查发现,对照组可见清晰3层结构,平均ADC值为[(1.60±0.26)×10~(-3)]mm~2/s;观察组病灶处呈现高信号,平均ADC值为[(0.86±0.17)×10~(-3)]mm~2/s,观察组平均ADC值显著低于对照组(P0.05)。腺癌与鳞癌患者(P0.05);低分化肿瘤患者ADC值显著低于中、高分化肿瘤患者(P0.05);不同国际妇产科联盟(FIGO)分期患者ADC值比较差异无统计学意义(P0.05);宫颈癌患者放疗结束后,依据实体瘤的疗效评价标准(RECIST):完全缓解(CR)19例,部分缓解(PR)16例;放疗前CR与PR患者ADC值比较差异无统计学意义(P0.05);放疗后CR与PR患者ADC值均高于放疗前,且CR组高于PR组(P0.05)。结论 DWI可以准确地反映宫颈癌的组织特点,ADC值可以客观评价宫颈癌恶性程度和放疗疗效。
[Abstract]:Objective to evaluate the value of Mr diffusion weighted imaging (DWI) in the evaluation of radiotherapy efficacy and prognosis of cervical cancer. Methods 35 patients with cervical cancer undergoing chemotherapy in our hospital were selected as the observation group. In addition, 30 patients with non-cervical cancer received pelvic magnetic resonance imaging (MRI) examination in our hospital were selected as control group. MRII-DWI was performed before and after treatment. After the image was processed, the apparent diffusion coefficient (ADC) was measured and compared between the two groups. Results DWI examination showed that the control group had a clear 3-layer structure with an average ADC value of [1.60 卤0.26) 脳 10 ~ (-3)] mm / s. The average ADC value was 0.86 卤0.17 脳 10 ~ (-3)) mm / s. The average ADC value in the observation group was significantly lower than that in the control group (P 0.05). The ADC value in the patients with adenocarcinoma and squamous cell carcinoma was significantly lower than that in the control group, and the ADC value in the patients with poorly differentiated tumors was significantly lower than that in the middle. There was no significant difference in ADC value in patients with highly differentiated tumor (P0.05); there was no significant difference in ADC value in patients with different stages of Gynaecology and Obstetrics; according to the criteria for evaluating the curative effect of solid tumor after radiotherapy, 19 cases had complete remission and 16 cases had partial remission. There was no significant difference in ADC between CR and PR patients before radiotherapy, and the ADC values of CR and PR patients after radiotherapy were higher than those before radiotherapy. Conclusion DWI can accurately reflect the histological characteristics of cervical cancer and can objectively evaluate the malignancy of cervical cancer and the curative effect of radiotherapy.
【作者单位】：锦州医科大学附属第一医院放射线科;锦州医科大学附属第一医院烧伤整形科;锦州医科大学附属第一医院放疗科;
【基金】：辽宁省博士科研启动基金计划资助项目(No.20121095)
【分类号】：R445.2;R737.33

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