基于DWI-ADC值动态监测宫颈癌放化疗疗效的临床研究

目的:通过DWI-ADC值测定动态监测宫颈癌放化疗疗效。方法:对2014年4月至2016年9月我院病理确诊的37例中晚期（FIGO分期Ⅱb-Ⅲb）宫颈鳞癌患者分别于同步放化疗前（A节点）、外照射治疗结束时（B节点）、后装内照射治疗3次时（C节点）、同步放化疗治疗结束时（D节点)行4次常规MRI及DWI检查。在ADC图上绘制ROI测量病灶、正常子宫肌层的ADC值；计算不同时间节点病灶的体积。所有数据经过统计学处理。结果:A、B、C、D时间节点病灶ADC值组间比较有明显差异(P<0.01)，从A→D节点病灶ADC值逐步上升，其中ADC值上升最明显的为B节点，增幅32.55%；病灶体积缩小最明显为B-C节点,缩小率为65.64%。D节点病灶与A节点正常子宫肌层的ADC值比较无统计学差异。结论:基于ADC值测定能够更早、更精确、定量地动态评估中晚期宫颈鳞癌同步放化疗效果，并对预后疗效给予准确预测。

Effect of DWI-ADC value on evaluating the efficacy of cervical cancer with concurrent chemoradiotherapy

Objective:To evaluate the efficacy of cervical cancer with concurrent chemoradiotherapy based on DWI-ADC value.Methods:37 advanced cervical cancer patients (FIGO stage Ⅱb-Ⅲb) diagnosed by pathological examination from April 2014 to September 2016 were examined by routine MRI and DWI for 4 times in our hospital，including before concurrent chemoradiotherapy (A node)，at the end of the external radiotherapy (B node)，after loading instracavitary irradiation therapy for 3 times (C node) and concurrent chemoradiotherapy at the end of treatment (D node).The ADC value of the lesions and normal myometrium were measured in ROI drawn on the ADC diagram.Also the volume of the lesions at different time points were calculated.All data were statistical analyzed.Results:ADC value of lesions had obvious significant differences among A，B，C，D node(P<0.01).ADC value gradually increased from A to D node，especially the B node，up to 32.55%.Lesion of B-C node had the most obvious volume reduction rate which was 65.64%.There was no significant difference of ADC value between D node and A node which myometrium was not invaded.Conclusion:Advanced cervical cancer patients response to concurrent chemoradiotherapy can be assessed by ADC value more early，accurately and quantitatively.Also，prognosis can be predicted more accurately.