扩散加权成像预测、监测宫颈癌放化疗效果  

Diffusion-weighted imaging in predicting and monitoring the response of uterine cervix cancer to concurrent chemoradiation

作　　者：刘颖[1] 白人驹[1] 孙浩然[1] 

机构地区：[1]天津医科大学总医院放射科,天津300052

出　　处：《中国医学影像技术》2009年第7期1269-1272,共4页Chinese Journal of Medical Imaging Technology

摘　　要：目的探讨扩散加权成像(DWI)在预测、监测宫颈癌放化疗效果中的应用价值。方法对17例接受放化疗的宫颈癌患者,于治疗前和治疗开始后1个月、2个月分别行常规MR平扫及DWI检查,其中8例患者于治疗开始后15d加行一次DWI检查。测量治疗前和治疗后不同时间点横轴位T2WI上肿瘤最大径和ADC值,分析各疗效组治疗前和治疗后不同时间点ADC值差异。结果肿瘤完全消失(CR)组治疗前平均ADC值明显低于肿瘤部分消失(PR)组(P<0.05);治疗后2个月肿瘤最大径缩小率与治疗前ADC值负相关(r=-0.574,P<0.05)。治疗后1个月肿瘤ADC值变化率与治疗后2个月肿瘤最大径缩小率呈正相关(r=0.572,P<0.05);治疗后15d与治疗前比较,平均ADC值升高(P<0.05),而肿瘤最大径与治疗前相比无明显变化(P>0.05)。结论宫颈癌治疗前DWI检查有助于预测放化疗疗效,治疗过程中DWI检查有助于早期监测和动态观察治疗效果。Objective To investigate the value of diffusion-weighted imaging （DWI） in predicting and monitoring the response of uterine cervix cancer to concurrent ehemoradiation. Methods Seventeen patients with uterine cervix cancer under went conventional MRI and DWI examinations before therapy and at one month and two months after the initiation of concurrent chemoradiation, and 8 of them underwent additional examinations at 15 d after therapy. The longest diameter of tumor before and after treatment was measured on axial T2WI. The mean ADC value among pre and post treatment of each group （CR, PR and SD） was compared. Results The mean ADC value before therapy of CR group was statistically lower than that of PR group （P〈0.05）. There was negative correlation between mean pretreatment ADC value and percentage size reduction of tumor after concurrent chemoradiation at two months （r=-0. 574, P〈0.05）. The percentage ADC change of tumor at one month correlated positively with percentage size reduction of tumor at two months after concurrent chemoradiation （r= 0. 572, P〈0.05）. Fifteen days after the initiation of concurrent chemoradiation, the mean ADC value of 8 patients increased significantly, however, the longest diameter of tumor showed no statistically significant changes compared with pre-treatment tumor diameter. Conclusion DWI has the ability to predict the response of uterine cervix cancer to concurrent ehemoradiation, and it can monitor the treatment response as well.

关 键 词：宫颈肿瘤 扩散加权成像 ADC值 放化疗 

分 类 号：R737.33[医药卫生—肿瘤] R445.2[医药卫生—临床医学]