MR扩散成像评价宫颈癌放(化)疗早期疗效  

Diffusion-weighted imaging evaluation of the effects of early(chemo-) radiation therapeutic of cervical cancers

作　　者：曹崑[1] 张晓鹏[1] 汪宁[1] 单军[1] 崔湧[1] 齐丽萍[1] 

机构地区：[1]北京大学临床肿瘤学院、北京肿瘤医院暨北京市肿瘤防治研究所医学影像科,恶性肿瘤发病机制及转化研究教育部重点实验室,北京100142

出　　处：《中国医学影像技术》2009年第9期1657-1660,共4页Chinese Journal of Medical Imaging Technology

基　　金：973国家重点基础研究发展计划基金(2006CB705706)

摘　　要：目的探讨磁共振扩散成像评价宫颈癌放(化)疗早期疗效的价值。方法收集21例经病理证实的以放(化)疗为治疗方式的宫颈癌患者,于治疗前、放疗开始后2～3周(早期点)、放疗结束时行常规MR成像及b值=1000s/mm2的扩散成像,于放疗结束点作为判断病灶是否残余的观察点。将病灶分为有、无残余两组。测量计算各病灶体积、平均ADC值,并将早期点的体积变化率与扩散ADC值的变化率进行比较。结果治疗早期点时,宫颈癌病灶体积缩小,ADC值升高,两者变化无相关性,体积缩小幅度比ADC值升高幅度明显(P<0.001)。有、无残余两组的体积变化率差异无统计学意义(P=0.082),但ADC值的升高率差异有统计学意义(P=0.018),有残余组平均ADC值变化幅度(17.06%)明显低于无残余组(27.03%)。结论ADC值的变化差异可能成为帮助早期判断宫颈癌放(化)疗后病灶是否易于残留的指标。Objective To explore the value of diffusion-weighted imaging（DWI） evaluation of the（chemo-） radiation therapeutic effects of cervical cancer.Methods Twenty-one patients pathologically diagnosed as cervical cancers and having received（chemo-） radiation were included.MR scans were performed three times：before therapy,2—3 weeks after the radiation initiated（early point） and after the treatment completed.DWI with b value 1000 s/mm2 was performed in all cases.The volumes of lesions were measured.Images of early time point were used to calculate the tumor shrinkage rate,volume changes and ADC changes were compared.Results In early points,the volumes of cervical cancers shrunk,while ADC values increased.The amplitude of volume shrinkage was higher than that of ADC value increase（P〈0.001）.There was no difference of volume change between residue and non-residue group,but the amplitude of ADC value change was significantly lower in residue group（17.06%） than that in non-residue group（27.03%）Conclusion The changes of ADC can be an indicator in diagnosis of residual lesions after（chemo-） radiation therapeutic of cervical cancer.

关 键 词：子宫颈肿瘤 磁共振成像 扩散加权成像 

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