~1H-MRS在宫颈癌放疗近期效果评估中的应用

The Application of ~1H-MRS in the Short-term Evaluation on Curative Effect of Radiotherapy on Cervical Carcinoma

目的:探讨氢质子磁共振波谱(1H-MRS)在子宫颈癌近期放疗疗效评估中的应用价值。方法:选取2015年6月-2016年7月笔者所在医院收治的经病理证实的宫颈癌患者37例,其中宫颈鳞癌33例,腺癌4例,全部病例均采用根治性放疗方案,于放疗前(G1)、放疗至22 Gy/10f(G2)、33 Gy/15 f(G3)、44 Gy/20 f(G4)及放疗结束(G5)同日进行MRI和1H-MRS扫描,采用Philips Achieva 3.0T磁共振成像仪及8通道体部线圈进行扫描,放疗疗效评判根据实体瘤疗效评价标准(RECIST 1.1版本),CR、PR为有效组,SD、PD为无效组,分析对比两组肿瘤放疗前及放疗过程不同阶段代谢物胆碱(Cho,3.22 ppm)的表达变化。结果:全部37例宫颈癌患者中,有效组30例,无效组7例;放疗有效组G4、G5的Cho峰值和Cho峰下面积比较差异均无统计学意义(P>0.05),G1~G3各次的Cho峰值和Cho峰下面积比较差异均有统计学意义(P<0.001);放疗无效组G1~G5的Cho峰值和Cho峰下面积比较差异均无统计学意义(P>0.05)。结论:宫颈癌1H-MRS参数Cho峰值和峰下面积在宫颈癌近期放疗疗效评估中具有一定的临床应用价值。

Objective:To explore the application of 1H-MRS in the evaluation of short-term curative effect of radiotherapy on cervical cancer.Method:From June 2015 to July 2016,37 patients who were pathologically confirmed with cervical carcinoma were involved in the study,including 33 cases of squamous cell carcinoma and 4 cases of adenocarcinoma.All of the patients were treated with radical radiotherapy.MRI and 1H-MRS sequence were performed on the same day before radiotherapy(G1),radiotherapy to 22 Gy/10 f(G2),33 Gy/15 f(G3),44 Gy/20 f(G4)and at the end of radiotherapy(G5).Philips Achieva 3.0T magnetic resonance image scanner and the 8-channel body coil were used for scanning.Radiotherapy efficacy was evaluated accords to Response Evaluation Criteria in Solid Tumors(RECIST1.1 version),CR,PR for the radiotherapy effective group,SD,PD for the radiotherapy ineffective group.Changes of choline(Cho,3.22 ppm)at different stages were detected before and during radiotherapy.Result:There were 30 responders and 7 non-responders in total 37 patients.There was no significant difference in Cho peak value and Cho peak area between G4 and G5 in radiotherapy effective group(P>0.05),and Cho peak value and Cho peak area of G1 to G3 were statistically different(P<0.001).There was no significant difference between the Cho peak and Cho peak area of G1 to G5 in the radiotherapy ineffective group(P>0.05).Conclusion:The MRS parameters Cho peak and area under the peak have a certain clinical value in the evaluation of short-term radiotherapy effect of cervical cancer.