MRI在卵巢恶性肿瘤诊治中的应用进展

Development of diagnosis and treatment of MRI in ovarian cancer

卵巢恶性肿瘤是妇科肿瘤中发现最晚、复发率最高的恶性肿瘤。70%以上的卵巢恶性肿瘤发现时都在临床Ⅲ期及以上,而临床Ⅲ期及以上的患者70%都会复发,卵巢癌的5年生存率<50%。磁共振成像(magnetic resonance imaging,MRI)在卵巢恶性肿瘤诊治中的应用日趋广泛,在许多肿瘤中心已经成为卵巢肿物超声的补充检查。MRI可应用于术前判断卵巢肿物的性质;描述卵巢恶性肿瘤的形态、分布及播散转移情况,预测临床分期;评估是否可行满意的肿瘤细胞减灭术;评估卵巢恶性肿瘤化疗的有效性,协助下一步治疗方案的确定。近年来,MRI在术前发现腹膜、肠系膜和膈肌病灶方面较CT有优势,在评估化疗的有效性时较以往的评估方法能更早期发现化疗不敏感,从而实现化疗的个体化。

Ovarian cancer is difficult to be detected in the malignant tumor of women and it has the high re-currence rate. More than 70% of malignant ovarian cancer were found in clinical stage III and above with the recurrence rate of 70%, and the survival rate of 5 years of ovarian cancer is below 50%. Magnetic reso-nance imaging（MRI） is used extensively in diagnosis and treatment of ovarian cancer. MRI is used as the supplement examination of ultrasound for ovarian masses in many cancer centers. MRI is used for charac-terization of complex adnexal masses; describing the morphology, distribution and metastasis of the ovarian cancer, forecasting the clinical stage; MRI is also used in the accurate identification of patients in whom up-front surgical cytoreduction is unlikely to be successful; appraising the effectiveness of chemotherapy in o-varian cancer, and guiding the following treatment. MRI detects peritoneal disease, bowel mesentery and diaphragmatic disease found at surgery with greater accuracy than CT. Early work suggests that MRI may be able to identify response to chemotherapy earlier in the course of treatment than other methods before, to al-low an individualized approach to chemotherapy treatment.