磁共振扩散成像在评估早期宫颈癌放疗化疗中的临床应用

Application Value of MR Diffusion Weighted Imaging in Predicting the Effect of Chemoradiotherapy for Cervical Cancer

目的探讨磁共振扩散成像(DWI)在评估早期宫颈癌放疗化疗中的临床应用价值。方法抽取2014年1月至2016年1月来我院拟行放疗化疗后手术治疗的早期宫颈癌患者80例,分别在放化疗前1天、放化疗中第14天和第28天(术前)给予常规盆腔MR和DWI扫描,测量并记录肿瘤的最大径和多点平均ADC值,比较肿瘤治疗前后的变化。结果治疗后与治疗前相比,肿瘤最大径无明显变化者其平均ADC值变化也不明显,肿瘤最大径有明显变化者其平均ADC值呈明显增高;术后病理显示ADC值明显上升者镜下组织炎性反应、细胞核异型性、肿瘤细胞死亡程度均比ADC值无明显变化着显著增大。结论 DWI能够为临床判断早期宫颈癌对放疗化疗反应性提供参考依据,有助于临床医师早期预测治疗效果,制定合理的治疗方案。

Objective To explore the application value of MR diffusion weighted imaging（DWI） in predicting the effect of Chemoradiotherapy for cervical cancer.Methods 80 patients with early cervical cancer undergoing Chemoradiotherapy before surgery were selected from January 2014 to January 2016,they were prefomed conventional pelvic MR and DWI scans on the day before Chemoradiotherapy,on the 14th day and the 28th day during Chemoradiotherapy（preoperative）.The maximum diameter of the tumor and multi-point average ADC value were measured and recorded,changes of the tumor were compared.Results Compared with before treatment,the mean ADC value of the tumor with no significant change in the maximum diameter of the tumor was not obvious,and the mean ADC value of the tumor was significantly increased when the maximum diameter of the tumor changed obviously;Postoperative pathology showed that microscopic inflammatory reaction,nuclear atypia and tumor cell death were obviously increased in patients with obvious ADC increase than those without obvious ADC change.Conclusion DWI can provide a reference for clinical judgment of early cervical cancer response to Chemoradiotherapy,which helps clinicians to predict the therapeutic effect in the early stage and make a reasonable treatment plan.