宫颈癌放射治疗疗效的MRI分析

目的分析宫颈癌放疗中与放疗后MRI表现，探讨MRI戍像对宫颈癌放疗疗效评估的临床价值。方法18例经病理证实的宫颈癌患者在放射治疗前及放射治疗中和治疗后不同时间段行盆腔MR扫描。在MRI图像上观察肿瘤在放射前后的大小及信号变化。结果（1）肿瘤大小放疗中7例肿瘤无明显缩小（缩小卒小于50％），10例肿瘤明显缩小（缩小率大于50％），1例肿瘤消失。全程放疗结束后，4例肿瘤无明显缩小（缩小率小于50％），12例肿瘤明显缩小（缩小率大于50％），2例肿瘤消失。（2）放疗中，3例肿瘤信号消失，15倒肿瘤信号无明显变化。全程放疗结束时，11例肿瘤信号消失。放疗结束2～3个月时，14例肿瘤信号消失，局部T2WI序列呈低信号。（3）放疗早期，6例肿瘤强化信号不均匀，出现“无强化区”，其中4例肿瘤缩小率小于50％，放射治疗结果为肿瘤残留。全程放疗结束时，11例肿瘤轻度强化或不强化。放疗结束2—3个月时，15例肿瘤不强化或轻微强化，其中14例肿瘤缩小率大于50％，放射治疗结果为肿瘤痊愈，仅1例有肿瘤残留。（4）放疗后宫旁等深部侵润肿瘤信号明显降低，肿大淋巴结缩小。结论MRI成像对宫颈癌放疗疗效及预后评估具有重要意义。

MRI evaluation of treatment effect of radiotherapy for cancer of uterine cervix

Objectives To present the findings of cervical carcinoma before,during and after radiation therapy by magnetic resonance （MR） imaging and to investigate MR images in the evaluation of certvical carcinoma response to radiation therapy. Methods Pelvic MR imaging was performed before, during, and at different intervals after radiation therapy in 18 patients with cervical carcinoma. The changes of carcinoma lesion in size and signal were evaluated on MR images. Results （1）During the radiation therapy, the extent of tumor volume shrinkage was less than 50% in 3 patients and more than 50% in 14 patients. Tumor disappeared in 1 patient. After radiation therapy, the extent of tumor volume shrinkage was less than 50% in 1patient and more than 50%in 10 patients. Tumor disappeared in 7 patients. （2） During the radiation therapy, the tumor signals disappeared in 3 patients and had no changes in 15 patients. After the radiation therapy, the tumor signals disappeared in 11 patients. In 2 to 3 monthes after the radiation therapy, the tumor signals disappeared in 14 tumors and showed hypointense signal on T2W1. （3）Acute changes during radiation therapy, ＂No enhancement carcinoma lesion was observed in 6 patients. When the radiation therapy was finished, slight or no enhancement was observed in 11 patients. In 2 to 3 monthes after radiotion therapy, slight or no enhancement was observed in 15 patients and 14 patients of them the extent of tumor volume shrinkage was more than 50%. Moreover, only 1 partient was demonstracted as having tumor residual after radiation treatment. （4）After the radiation therapy, signal of parametrium tumor obvious lower, lymphoid knots contrast. Conclusion MRI imaging is helpful in evaluating cervical carcinoma response to radiation therapy and making the therapeutic plan.