基于DWI-ADC值动态监测宫颈癌放化疗疗效的临床研究

Effect of DWI-ADC value on evaluating the efficacy of cervical cancer with concurrent chemoradiotherapy

目的:通过DWI-ADC值测定动态监测宫颈癌放化疗疗效。方法:对2014年4月至2016年9月我院病理确诊的37例中晚期(FIGO分期Ⅱ_b-Ⅲ_b)宫颈鳞癌患者分别于同步放化疗前(A节点)、外照射治疗结束时(B节点)、后装内照射治疗3次时(C节点)、同步放化疗治疗结束时(D节点)行4次常规MRI及DWI检查。在ADC图上绘制ROI测量病灶、正常子宫肌层的ADC值;计算不同时间节点病灶的体积。所有数据经过统计学处理。结果:A、B、C、D时间节点病灶ADC值组间比较有明显差异(P<0.01),从A→D节点病灶ADC值逐步上升,其中ADC值上升最明显的为B节点,增幅32.55%;病灶体积缩小最明显为B-C节点,缩小率为65.64%。D节点病灶与A节点正常子宫肌层的ADC值比较无统计学差异。结论:基于ADC值测定能够更早、更精确、定量地动态评估中晚期宫颈鳞癌同步放化疗效果,并对预后疗效给予准确预测。

Objective ： To evaluate the efficacy of cervical cancer with concurrent chemoradiotherapy based on DWI -ADC value. Methods ：37 advanced cervical cancer patients （FIGO stage ]1 b - ]]I b ） diagnosed by pathological ex- amination from April 2014 to September 2016 were examined by routine MRI and DWI for 4 times in our hospital, in- eluding before concurrent chemoradiolherapy （A node）, at the end of the exlernal radiotherapy （B node）, after load- ing instraeavitary irradiation therapy for 3 times （C node） and concurrent ehemoradiotherapy at the end of treatment （ D node）. The ADC value of the lesions and normal my-ometriunl were measured in ROI drawn on the ADC diagranL Also the volume of the lesions at different time points were calculated. All data were statistical analyzed. Results ： ADC value of lesions had obvious significant differences among A, B, C, D node（P 〈 0.01 ）. ADC value gradually increased fronl A to D node ,especially- the B node ,up m 32.55%. Lesion of B - C node had the most obvious volume reduction rate which was 65.64%. There was no significant difference of ADC value between D node and A node which my-ome- triton was not invaded. Conclusion：Advanced cervical cancer patients response to concurrent ehemoradiotherapy can be assessed by ADC value more early, accurately and quantitatively. Also, prognosis can be predicted more accurately.