扩散加权成像预测宫颈癌放化疗反应的研究  

Study on diffusion-weighted imaging as a predictive marker for chemoradiotherapy response in cervical canc-er patients

作　　者：章顺壮[1] 马周鹏[1] 苗永兴[2] 周建军[3] 

机构地区：[1]慈溪市人民医院放射科,浙江省慈溪315300 [2]慈溪市人民医院放化疗科,浙江省慈溪315300 [3]复旦大学附属中山医院

出　　处：《中国基层医药》2014年第9期1305-1306,共2页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的：观察宫颈癌根治术后复发的患者扩散加权成像（ DWI）特点及其与放化疗反应之间的关系。方法以26例宫颈癌根治术后复发患者为研究对象，在放化疗前后进行常规磁共振扫描和DWI检查。记录肿瘤的基线特点包括复发部位、大体肿瘤体积、坏死区和ADC值，勾画扩散受限局灶作为一个单独的ROI并测量ADC值。按完全反应（ CR组）、部分反应（ PR组）分组，比较组间的影像学特点。结果12例为CR组，14例为PR组。部分反应患者放化疗后的ADC值显著高于放化疗前的ADC值。与CR组相比，PR组患者具有更大的大体肿瘤体积、更高的ADC值和更多的扩散受限局灶，而复发类型、坏死区域未见显著差异。结论应用DWI获得的ADC值和扩散受限局灶有助于判断宫颈癌复发癌灶对放化疗的反应，这有助于临床医师早期预测治疗效果，对于合理制定方案、提高治疗效果具有重要意义。Objective To observe the relationship between diffusion-weighted imaging （ DWI） characteristics and chemoradiotherapy response in recurrence patients with radical hysterectomy .Methods 26 recurrence patients with radical hysterectomy were included .All underwent conventional MRI and DWI before and after chemoradiotherapy . Baseline tumor characteristics including recurrence site ,gross tumor volume ,necrotic area and the ADC value were re-corded.Focal regions of restricted diffusion were delineated as a separate ROI and ADC value was determined .Ima-ging features were compared between complete response group and partial response group .Results 12 patients had complete response （ CR group ） ,14 patients had partial response （ PR group ） .ADC valueafter chemoradiotherapy was significantly higher than that before chemoradiotherapy in PR patients .Compared with CR group ,PR group had a grea-ter gross tumor volume ,higher ADC value and more focal regions of restricted diffusion .Recurrence type and necrotic areas was no significant differences .Conclusion ADC value and focal regions of restricted diffusion adquired by DWI help to determine chemoradiotherapy response in recurrence patients with radical hysterectomy ,which is helpful for clinicians to predic treatment effect early .It has great significance for developing reasonable programs and impro-ving the therapeutic effect .

关 键 词：磁共振成像 化放疗 宫颈肿瘤 

分 类 号：R445.2[医药卫生—影像医学与核医学]