MRI成像对宫颈癌放射治疗疗效评估的价值

Value of MRI in Evaluating the Curative Effect of Radiotherapy for Cervical Cancer

目的分析磁共振成像(MRI)成像对宫颈癌放射治疗疗效评估的价值。方法回顾性分析2016年6月至2019年9月在本院接受放射治疗64例宫颈癌患者,采用实体瘤的疗效评价标准(RECIST)评估患者的放疗疗效,根据临床疗效分为缓解组(完全缓解+部分缓解)和未缓解组(疾病稳定+疾病进展)。所有纳入患者均经MRI检测,分析表观扩散系数(ADC)值,记录患者的年龄、FIGO分期、分化程度、肿瘤直径等临床特征。Pearson相关性分析ADC值与放疗疗效之间的相关性。结果64例宫颈癌患者经放射治疗后,完全缓解14例(21.88%),部分缓解34例(53.13%),疾病稳定13例(20.31%),疾病进展3例(4.69%)。宫颈癌患者在MRI上表现为T1WI信号呈等低信号,T2WI序列呈不均匀高信号,DWI呈高信号,ADC图呈低信号,且放疗后的肿瘤直径明显小于放疗前(P<0.05),ADC值明显高于放疗前(P<0.05);放疗前后,缓解组患者的ADC值明显高于未缓解组(P<0.05),且FIGO分期越高,肿瘤直径越长,放疗后的ADC值越低(P<0.05);宫颈癌患者放疗后的ADC值与疗效具有显著的相关性(r=-0.431,P<0.05)。结论MRI成像对宫颈癌放射治疗的疗效评价具有较高的应用价值,值得临床推广应用。

Objective To analyze the value of magnetic resonance imaging(MRI)in evaluating the curative effect of radiotherapy for cervical cancer.Methods A retrospective analysis was performed among 64 patients with cervical cancer admitted to the hospital from June 2016 to September 2019.The response evaluation criteria in solid tumours(RECIST)was used to evaluate the curative effect of radiotherapy.The patients were divided into the remission group(remission+partial remission)and the nonremission group(stable disease+disease progression)according to the clinical effect.All patients were examined by MRI,and the apparent diffusion coefficient(ADC)value was analyzed.The clinical characteristics such as age,FIGO stage,differentiation degree and tumor diameter were recorded.Pearson correlation analysis was performed to analyze the correlation between ADC value and the curative effect of radiotherapy.Results After radiotherapy,among the 64 patients with cervical cancer,there were 14 cases(21.88%)with complete remission,34 cases(53.13%)with partial remission,13 cases(20.31%)with stable disease and 3 cases(4.69%)with disease progression.MRI of patients with cervical cancer showed equal low signal on T1WI,uneven high signal on T2WI,high signal on DWI and low signal on ADC map.The tumor diameter after radiotherapy was significantly smaller than that before radiotherapy(P<0.05),while the ADC value was significantly higher than that before radiotherapy(P<0.05).ADC values of the remission group were significantly higher than those of the non-remission group before and after radiotherapy(P<0.05).Besides,the higher the FIGO stage,the longer the tumor diameter and the lower the ADC value(P<0.05).There was an obvious correlation between the ADC value of patients with cervical cancer after radiotherapy and the curative effect(r=-0.431,P<0.05).Conclusion MRI imaging has high application value in evaluating the curative effect of radiotherapy for cervical cancer,and it is worthy of clinical application.