磁共振弥散加权成像预测宫颈癌早期放化疗疗效及预后  

Role of Magnetic Resonance Diffusion Weighted Imaging on Predicting Curative Effect in Early Stage and Prognosis of Patients with Cervical Cancer after Radiation and Chemotherapy

作　　者：曾晓红[1] 黄荣[1] 蒋军[1] 何瀚[1] 邹育超[1] 周菲菲[1] 闵燕飞[1] 陈默[1] ZENG Xiao-hong HUANG Rong JIANG Jun HE Hart ZOU Yu-chao ZHOU Fei-fei MIN Yan-fei CHEN Mo(Department of Thoracic and Abdominal Racdiotherapy, The First People＇s Hospital of Foshan, Foshan, Guangdong, 528000, Chin)

机构地区：[1]佛山市第一人民医院胸腹放疗科,广东佛山528000

出　　处：《现代生物医学进展》2016年第35期6932-6935,共4页Progress in Modern Biomedicine

摘　　要：目的：探讨磁共振弥散加权成像（DWI）在预测宫颈癌患者早期放化疗效果及预后的应用价值。方法：选择2011年2月~2014年2月在我院住院并接受同期放化疗的宫颈癌患者共74例,于放化疗前、放化疗中、放化疗结束时进行磁共振（MR）扫描及DWI检查。记录不同时间段的肿瘤体积和宫颈癌表观弥散系数（ADC）变化,依据实体瘤的疗效评价标准（RECIST）标准比较放化疗前后不同疗效组ADC值及其变化率。对患者进行18个月的随访,以病理切片检查结果为金标准,分析DWI对宫颈癌复发诊断的灵敏度和特异度。结果：放化疗前、中、结束时患者的肿瘤体积和ADC值差异具有统计学意义（P〈0.05）;与放化疗前相比,不同疗效组放化疗后的ADC值均明显升高（P〈0.05）,且放化疗后各组ADC值和ADC变化率之间差异均具有统计学意义（P〈0.05）;DWI对宫颈癌复发诊断的灵敏度和特异度分别为95.83%和95.45%。结论：DWI可以预测宫颈癌早期放化疗临床疗效,并对患者预后评估具有较高的灵敏度和特异度,值得在临床上广泛推广。Objective： To study application value of magnetic resonance diffusion weighted imaging （DWl）on predicting curative effect in early stage and prognosis of patients with cervical cancer after radiation and chemotherapy. Methods： 74 cases of patients with cervical cancer who hospitalized and treated by radiation and chemotherapy in our hospital from February 2011 to February 2014 were selected,they were preformed magnetic resonance （MR） scanning and DWI examination before,during and at the end of the radiation and chemotherapy separately. The tumor size and apparent diffusion coefficient（ADC） of cervical cancer were recorded, meanwhile the ADC values and its change rate of different therapeutic groups which divided according to response evaluation criteria in solid tumors （RE- CIST）standard were compared before and after the radiation and chemotherapy. Followed up 18 months, took the pathological biopsy resuits as the gold standard, analyzed the sensitivity and specificity of DWI in diagnosis of cervical cancer recurrence. Results： The differences of tumor size and ADC values of patients before, during and at the end of radiation and chemotherapy were statistically significant （P〈0.05）; Compared with before radiation and chemotherapy, the ADC values of different therapeutic groups were significantly increased after radiation and chemotherapy （P〈0.05）, and the differences of ADC values and its change rate in each group after radiation and chemotherapy were statistically significant （P〈0.05）; The sensitivity and specificity of DWI in diagnosis of cervical cancer recurrence were 95.83% and 95.45% respectively. Conclusion： DWI can predict the clinical curative effect in early stage of patients with cervical cancer, and has high sensitivity and specificity on evaluate the prognosis,which is worth popularizing in clinic widely.

关 键 词：宫颈癌 弥散加权成像 表观弥散系数 放化疗 

分 类 号：R737.33[医药卫生—肿瘤]