磁共振弥散加权成像在中晚期宫颈癌放射治疗中的应用

Diffusion-weighted imaging in predicting and monitoring the response of advanced cervical cancer to combined radiotherapy

目的本研究对正常子宫颈及宫颈癌组织放疗前后的弥散加权成像(diffusion-weighted imaging,DWI)特点进行分析,并探讨DWI在宫颈癌放疗疗效监测方面的价值。方法对15例非宫颈肿瘤女性的子宫颈和45例宫颈癌患者放疗前后的宫颈癌灶进行常规磁共振成像(magnetic resonance imaging,MRI)扫描和横断面DWI(b=700 s.mm-2),比较正常宫颈和放疗前后宫颈癌病灶的表观弥散系数(apparent diffusion coefficient,ADC)值,并比较放疗前后宫颈癌灶与两侧臀大肌组织的ADC值。结果正常子宫颈平均ADC值[(1.762±0.119)×10-3mm2.s-1]显著高于宫颈癌的ADC值[(0.891±0.130)×10-3mm2.s-1](t=20.199,P<0.05)。放疗后子宫颈的ADC值[(1.670±0.120)×10-3mm2.s-1]较放疗前相应部位升高(t=25.889,P<0.05),但较正常子宫颈及放疗后两侧臀大肌组织ADC值降低。结论 DWI能够区分正常子宫颈和宫颈癌组织,显示放疗前后宫颈癌灶组织的改变,有利于监测及评价宫颈癌放疗疗效。

Objective To analyze the diffusion weighted imaging （DWI） features of normal uterine cervix and cervical carcinoma before and after radiotherapy,and to assess the values of DWI in monitoring of cervical carcinoma after radiotherapy. Methods Routine mag- netic resonance imaging（MRI） sequence and axial diffusion weighted sequence（ b = 700 s ·mm-2） were performed in 45 patients with cervical carcinoma and in 15 healthy women as control. The apparent diffusion coefficient（ADC） values of normal uterine cervix and cer- vical carcinoma before and after radiotherapy were compared.