磁共振成像观察宫颈癌放疗后盆部软组织变化

目的分析宫颈癌放疗中与放疗后盆部软组织、器官的异常MR表现.探讨MR成像对显示盆部软组织损伤的临床价值.方法 38例经病理证实的宫颈癌患者在放射治疗前及治疗中和治疗后不同时间段行盆腔MR扫描.在MR图像上观察盆部软组织、器官在放疗前后的大小及信号改变.结果放疗可引起多个组织、器官的异常MR表现.异常MR表现发生率在40%以上的有直肠、直肠筋膜、宫旁组织、盆壁肌肉与皮下脂肪.直肠、膀胱、子宫的异常MR表现在放疗后6个月可消失.结论 MR成像可对盆部软组织的射线损伤进行实时监测,对宫颈癌放射治疗有指导意义.

Soft tissues of pelvis in patients with cervical cancer: MRI before, during, and after radiation therapy

Objective To present the findings of the irradiated soft tissues of pelvis in patients with cervical cancer at magnetic resonance imaging (MRI)during and after radiation therapy (RT), and to investigate the clinical value of MR imaging in demonstration of the irradiated soft tissues of pelvis. Methods Pelvic MR imaging was performed in 38 patients with cervical carcinoma before, during, and after radiation therapy. The MR scanning included axial SE T1W, axial and sagittal TSE T2WI, coronal SPIR TSE T2WI, and axial, sagittal and coronal Gd-DTPA enhanced SE T1WI. The changes of pelvic soft tissues and organs in size and signal were observed at MR images. Results Abnormality was detected in muli-tissue and organ at MR imaging after RT. Abnormal appearance was demonstrated in the rectum, perirectal fascia, parametrium, muscles and subcutaneous fat in more than 40% of patients. Abnormality at MR imaging appeared in rectum, bladder, uterine was transient and disappeared in 6 months after RT. Radiation-induced abnormality at MR images to all soft tissues and organs of pelvis was more frequently seen at the end of external beam radiotherapy (EBRT) than another time, and was dose-dependent of EBRT. Conclusion MR can detect radiation-induced soft tissue changes during and after RT and may be of value in designing radiation treatment schedules for cervical carcinoma.