低场强MRI诊断放射治疗前后宫颈癌的临床价值

The value of low field strength MRI in diagnosis and evaluation of the therapeutic effect of radiotherapy on uterus cervical cancer

目的:探讨低场强MRI在子宫颈癌(UCC)及其放射治疗后的诊断价值。方法:89例经病理学证实为UCC在治疗前根据低场强MRI表现做出临床分期,并与手术及外科探查术结果相对照;其中45例UCC在放疗后行低场强MRI复查。结果:UCCMRI T2WI呈均匀或不均匀高信号软组织肿块,T1WI呈等或低信号,增强扫描呈不均匀增强;对术前低场强MRI UCC分期的准确率为97.8%(87/89),放疗后肿瘤组织纤维化,T2WI表现为低信号。结论:MRI平扫T2WI为UCC检查的首选序列;低场强MRI在检测UCC肿瘤大小、宫旁浸润及转移等方面有优越性,有助于临床分期及监测UCC对放疗的反应。

Objective: To evaluate the value of low field strength MRI in the diagnosis,preoperative staging and tumor response to radiotherapy of uterus cervical cancers(UCC).Methods:The findings and staging of UCC with MRIwas evaluated prospectively in 89 patients with histological proven tumor and then compared with surgical pathologic results as the reference standard.45 patients with UCC who underwent radiotherapy were examined again to assess the effectiveness of radiotherapy treatment.Results:UCC showed heterogeneous and homogeneous hyperintensity on T2WI,hypointensity and isointensity on T1WI,mild heterogeneous enchancement after bolus intravenous Gd2DTPA.MR imaging had an accuracy of 97.8%(87/89)in demonstrating preoperative staging.Post irradiated UCC with hypointensity on T2WI indicated fibrosis in 8 cases reached clinical cure.Conclusion:T2 weighted turbo spin echo(FSE)sequence is the first choice in examining UCC.Low field strength MRI is a highly promising method for accurately demonstrating Size,local infiltration and distant site metastasis and preoperative staging of UCC.Low field strength MRI might provide exact guidance to answering crucial questions regarding effect and tumor response to radiotherapy.