MR弥散加权成像在评估宫颈癌放化疗疗效中的应用价值

目的探讨磁共振弥散加权成像DWI在评估宫颈癌放化疗疗效中的应用价值。方法 32例经病理证实为宫颈癌的患者,分别在治疗前和外照射20GY后进行常规的盆腔MRI扫描和DWI扫描,并测量肿瘤的最大径和ADC值。治疗结束6个月随访,根据RECIST标准将患者分成有效组和无效组。比较两组治疗前、外照射20GY后肿瘤的ADC值和ADC值提高率,并比较两组治疗前、外照射20GY后肿瘤的最大径及退缩率。结果有效组25例,无效组7例,两组治疗前、外照射20GY后的ADC值和最大径、退缩率无统计学差异(P0.05),而两组的ADC值提高率有统计学差异(P0.05)。结论宫颈癌有效组在治疗早期ADC值的提高率明显高于无效组,证实DWI序列能早期预测宫颈癌放化疗的治疗效果,为优化患者后续的治疗方案提供帮助。

Significance of MR Diffusion Weighted Imaging in Evaluating the Efficacy of Radiochemotherapy for Cervical Carcinoma

Objective To explore the significance of MR diffusion weighted imaging (DWI) in evaluating the efficacy of radiochemotherapy for cervical carcinoma.Methods 32 patients pathologically confirmed with cervical carcinoma underwent routine pelvic MRI plain scan and DWI scan, and the longest tumor dimension and ADC value were determined before treatment and following external radiation at 20GY. Patients were followed up for 6 months following completion of treatment, and were assigned to the response group or non-response group according to RECIST. The ADC value and increase rate of ADC value, as well as the longest tumor dimension and tumor shrinkage rate, were compared between the two groups before treatment and following external radiation at 20GY.Results Between the response group including 25 patients and the non-response group including 7 patients, there were no statistically significant differences in ADC value, longest tumor dimension or tumor shrinkage rate(P>0.05), but statistically significant difference in increase rate of ADC value(P<0.05) before treatment and following external radiation at 20GY.Conclusion The increase rate of ADC value in the early treatment period was significantly higher in the response group than in the non-response group of cervical carcinoma, confirming that DWI sequence could present an early predictor of the therapeutic effect of radiochemotherapy for cervical carcinoma, thus providing evidence for optimizing the subsequent treatment regimen.