DCE-MRI定量参数在宫颈癌放化疗效果评价及其与病理特征的相关性分析

Quantitative parameters of DCE-MRI in evaluating the efficacy of radiotherapy and chemotherapy for cervical cancer and their correlation with pathological features

目的探讨动态增强磁共振功能成像(DCE-MRI)定量参数对宫颈癌放化疗效果评价中的价值,及其与宫颈癌患者病理特征的相关性。方法选取2016年8月~2018年2月在我院接受放化疗治疗且在放化疗前后进行DCE-MRI扫描的宫颈癌患者45例为宫颈癌组,另选取同时期在我院进行DCE-MRI扫描的正常宫颈者58例为对照组,对比宫颈癌患者与正常宫颈者DCE-MRI定量参数,并对比宫颈癌患者放化疗前后DCE-MRI定量参数变化,同时分析DCE-MRI定量参数与宫颈癌病理特征的相关性。结果宫颈癌组患者的Ve、Ktrans、Kep显著高于对照组(P<0.05);45例患者治疗前平均肿瘤面积为(6.12±2.18)cm2,治疗末平均肿瘤面积为(1.64±0.38)cm2,肿瘤消退率为(82.18±2.13)%,经相关性分析显示,Ve、Ktrans、Kep均与宫颈癌肿瘤消退率呈显著正相关(P<0.01);不同病理类型宫颈癌患者Ve、Kep对比差异无统计学意义(P>0.05),宫颈鳞癌患者的Ktrans明显高于腺癌(P<0.05),不同分化程度宫颈癌患者的Ve对比差异无统计学意义,低分化宫颈癌患者的Ktrans、Kep显著高于中高分化患者(P<0.05),临床分期为IIIA期及以上宫颈癌患者Ve、Ktrans、Kep显著高于临床分期为IB^IIB期的患者(P<0.05),淋巴结是否转移、脉管是否浸润宫颈癌患者之间Ve、Ktrans、Kep对比差异无统计学意义(P>0.05)。结论DCE-MRI定量参数对宫颈癌放化疗效果及宫颈癌患者的病理学特性具有一定的评估价值。

Objective To explore the value of quantitative parameters of dynamic contrast-enhanced magnetic resonance imaging(DCE-MRI)in evaluating the effect of radiotherapy and chemotherapy for cervical cancer and its correlation with pathological characteristics of cervical cancer patients.Methods From August 2016 to February 2018,45 patients with cervical cancer who received radiotherapy and chemotherapy and received DCE-MRI scan before and after radiotherapy and chemotherapy were selected as cervical cancer group,and 58 normal cervical patients who underwent DCE-MRI scan at the same time were selected as control group.DCE-MRI quantitative parameters of cervical cancer patients and normal cervical patients were compared,and DCE-MRI determination of cervical cancer patients before and after radiotherapy and chemotherapy was compared.Meanwhile,the correlation between DCE-MRI quantitative parameters and pathological features of cervical cancer was analyzed.Results Ve,Ktrans and Kep in cervical cancer group were significantly higher than those in control group(P<0.05).The average tumor area before treatment was(6.12±2.18)cm2,the average tumor area at the end of treatment was(1.64±0.38)cm2,and the tumor regression rate was(82.18±2.13)%.The correlation analysis showed that Ve,Ktrans and Kep were positively correlated with the regression rate of cervical cancer(P<0.01).There was no significant difference between Ve and Kep in patients with type cervical cancer(P>0.05).Ktrans in patients with cervical squamous cell carcinoma was significantly higher than that in patients with adenocarcinoma(P<0.05).Ve in patients with differentiated cervical cancer had no significant difference.Ktrans and Kep in patients with poorly differentiated cervical cancer were significantly higher than those in patients with moderately differentiated cervical cancer(P<0.05).Ve,Ktrans and Kep in patients with clinical stage IIIA or above were significantly higher than those ofⅠB~ⅡB stage.There was no significant difference in Ve,Ktrans and Kep between patients with IB^IIB stage(P<0.05),lymph node metastasis and vascular invasion(P>0.05).Conclusion Quantitative parameters of DCE-MRI have certain value in e-valuating the effect of radiotherapy and chemotherapy for cervical cancer and the pathological characteristics of patients with cervical cancer.