3.0 T MR及DWI在宫颈癌放射治疗中的应用研究

目的 探讨3.0 T MR及扩散加权成像(diffusion weighted imaging,DWI)在宫颈癌放射治疗(放疗)中的应用价值.资料与方法 16例宫颈癌患者放疗前及放疗40 Gy后均进行MR平扫及自由呼吸状态下轴位DWI,b值取0、1000 s/mm~2,分别测量放疗前后肿瘤区表观扩散系数(ADC)值,并作统计学分析.结果 宫颈癌放疗前T_1 WI示病灶呈等信号、T_2WI呈较高信号,DWI呈均匀明显高信号,ADC值平均约(0.99±0.07)×10~(-3)mm~2/s;放疗后病灶明显缩小,DWI信号减低,呈低信号或高低混杂信号,ADC值平均约(1.52 ±0.08)×10~(-3)mm~2/s.放疗前后ADC值差异具有统计学意义(P<0.01).结论 宫颈癌放疗前DWI呈明显高信号,放疗后DWI信号减低,且不均匀,ADC值较放疗前明显增高,DWI可以作为官颈癌放疗监测的理想手段之一.

The Applied Research of 3.0T MRI and DWI in Monitoring Therapeutic Effect of Uterine Cervix Cancer with Radiotherapy

Objective To research the contribution of 3.0T MRI and diffusion weighted imaging in monitoring therapeutic effect of uterine cervix cancer with radiotherapy. Materials and Methods 16 eases with uterine cervix cancer were performed axial DWI without breath-hold before and after radiotherapy respectively with the same parameters. The b value was 0,1000 s/mm~2. The ADC values of tumor before and after radiotherapy were measured respectively. Statistic analysis was performed. Results The lesions of 16 cases with uterine cervix cancer before radiotherapy showed iso-intensity on T_1WI, slight hyper-intensity on T_2WI and significant uniform hyper-intensity on DWI. The average ADC value of 16 cases with uterine cervix cancer before radiotherapy was (0.99±0.07)×10~(-3) mm~2/s. The tumors after radiotherapy became smaller And the signal intensity on DWI of tumor became lower and more nonuniform than before. The average ADC value of 16 cases with uterine cervix cancer after radiotherapy was (1.52±0.08)×10~(-3) mm~2/s. The difference had statistic significance (P < 0.01). Conclusion The lesion of uterine cervix cancer before radiotherapy show significant uniform byper-intensity on DWI. The signal intensity of tumor after radiotherapy is lower and more nonuniform than before. The average ADC value after radiotherapy is higher than that before radiotherapy. DWI will be an ideal tool to monitor the radiotherapeutic effect on uterine cervix cancer.