DWI对放化疗后骨盆骨髓转化评估价值分析

DWI for assessing changes in pelvic bone marrow conversion due to radiotherapy and chemotherapy

目的探讨DWI评估放化疗后骨盆骨髓转化的临床价值。方法选取36例中晚期直肠癌患者放化疗前后的盆腔MRI资料,根据骨盆骨髓T_(1)WI、DWI整体信号与肌肉比对进行分型,测量骨盆骨髓与肌肉信号强度及ADC值,分析比较放化疗前后骨髓信号分型、信号强度比及ADC值变化。结果患者平均年龄为(56.0±12.2)岁。放化疗前后骨盆骨髓T_(1)WI、DWI分型、信号强度比及ADC值变化明显,差异有统计学意义(P<0.05),且放化疗前后DWI较T_(1)WI信号强度比变化更显著,差异有统计学意义(P<0.05)。结论DWI可反映放化疗后骨髓转化的过程,这为观察骨髓变化提供了新的思路。

Objective To assess bone marrow changes after radiotherapy and chemotherapy using DWI in advanced rectal cancer.Methods We retrospectively analyzed MRI data in advanced rectal cancer undergoing radiotherapy and chemotherapy.A total of 36 patients were included in the study,inchueing 22 males and 14 females,aged 34~83,with an average age of 56.0±12.2.First,the pelvic bone marrow signal intensity characteristics were divided into four types in T_(1)WI and three types in DWI.Then the pelvic bone marrow to muscle signal intensity ratio and ADC values were measured.Finally,the changes of bone marrow signal typing,signal intensity ratio and ADC values were compared and analyzed undergoing radiotherapy and chemotherapy.Results There were significant differences in the signal patterns and signal intensity ratio of T_(1)WI and DWI in pelvic bone marrow after treatment,as compared with those before treatment(P<0.05),and similar finding of significant difference of the ADC values.There were significant differences in T_(1)WI and DWI signal intensity ratio change value between pre-and post-treatment(P<0.05).Conclusion Radiotherapy and chemotherapy could accelerate bone marrow conversion.The DWI is sensitive in detecting bone marrow changes after radiotherapy and chemotherapy,which provides a new way for bone marrow research.