MRI动态增强扫描对宫颈癌放疗疗效评价研究

目的探讨利用MRI动态增强扫描对宫颈癌放疗疗效进行评估。方法对32例放疗前后宫颈癌患者进行常规盆腔MRI扫描和矢状位动态增强扫描,选取ROI绘制宫颈癌病灶及子宫正常组织的动态增强时间-信号曲线。测量相对信号强化率（RE%）和最大相对信号强化率（MRE%）;并进行统计学分析。结果宫颈癌病灶在动态增强扫描中明显强化,放化疗后1个月内肿瘤较前不同程度缩小,强化后信号仍较高;放疗后3个月～1年肿块明显缩小,其中19例肿块消失,病变部位强化程度明显减低或不强化。宫颈癌放疗前与放疗后1个月内测量宫颈病灶—子宫肌层的差值比较,其RE值差值比较差异无统计学意义（P〉0.05）,而MRE差值比较差异有统计学意义（P〈0.05）。宫颈癌放疗后1月内与放疗后3个月以上测量宫颈病灶比较,其RE、MRE差异有统计学意义（P〈0.05）。宫颈癌放疗后3个月以上与放疗前测量宫颈病灶—子宫肌层的差值比较,其RE、MRE值比较差异有统计学意义（P〈0.05）。宫颈癌放疗后1个月内与放疗后3个月以上测量宫颈病灶—子宫肌层的差值比较,其RE、MRE比较差异有统计学意义（P〈0.05）。结论 MRI动态增强扫描能够反映宫颈癌组织的血供状态,准确评估肿瘤情况,对宫颈癌放疗前进行分期并对放疗后疗效进行评价具有较高临床价值。

EFFICACY OF RADIOTHERAPY FOR CERVICAL CANCER WITH DYNAMIC CONTRAST-ENHANCED MRI

Objective To evaluate the efficacy of radiotherapy for cervical cancer with dynamic contrastenhanced MRI.Methods The data from32 cases of cervical cancer patients before and after radiotherapy for routine pelvic MRI scans and sagittal dynamic enhanced MRI were analyzed.Time-intensity curves of ROI in pathological regions and normal regions were obtained and the enhancedrates at different times were calculated.The RE,MRE of various groups were compared.Results In dynamic enhanced scan,we found significantly enhanced cervical lesions,radiotherapy within 1 month after treatment,the tumor shrank to varying degrees than before,the enhanced signal was still high.Radiotherapy after 3 months to 1 year review,mass was significantly reduced,where 19 cases of tumors disappeared,the lesion was significantly lower degree of enhancement or no enhancement.Radiotherapy before and 1 month after radiotherapy for cervical lesions and comparing the difference between the myometrium,the RE value showed no significant difference（P〉0.05）,while MRE value had significant difference（P〈0.05）.Within 1 month after radiotherapy and 3 months after radiotherapy for cervical lesions compared to its RE and MRE values were significantly different（P〈0.05）.More than3 months after radiotherapy with radiotherapy for cervical lesions before the difference compared with the myometrium,the RE and MRE values were significantly different（P〈0.05）.Within1 month after radiotherapy with radiotherapy more than3 months after the myometrium of cervical lesions and the difference compared to its RE and MRE were significantly different（P〈0.05）.Conclusions Dynamic contrast-enhanced MR imaging can reflect the blood supply of the tumor,accurate assessment of tumor cases,which can help to accurate staging before radiotherapy and after radiotherapy,with high clinical value.