磁共振成像在中晚期宫颈癌诊断及放射治疗疗效评价中的初步研究

摘要

目的：分析宫颈癌放射治疗前后磁共振成像（MRI）表现，探讨MRI在宫颈癌放射治疗疗效评估中的价值。方法21例宫颈癌患者在放射治疗前、后不同时间行盆腔MRI检查。比较其FIGO分期与MRI分期；观察肿瘤组织在放射治疗前、后的形态及MRI信号变化。结果患者治疗前MRI分期在显示宫旁、盆壁受侵及远处转移方面均优于FIGO分期。放疗结束后6个月，所有肿瘤缩小率在90%以上，其中17例肿瘤病灶完全消失。肿瘤治愈表现为原肿瘤区T2WI、脂肪抑制呈低信号，T1增强呈轻微强化或无强化。结论 MRI能清晰显示宫颈癌肿瘤大小及侵犯范围，分期客观准确；MRI对放射治疗疗效的评价有重要意义。%Objective To present the finding of cervical carcinoma before and after radiotherapy by magnet-ic resonance (MR) imaging, evaluate the value of MR imaging in cervical cancer radiotherapy. Methods Twenty-one patients with biopsy-proven invasive cervical cancer underwent pelvic MR imaging before and after radiotherapy. FI-GO stage and MR imaging stage were compared. The changes of carcinoma lesion in size and signal were evaluated. Results MR imaging stage is superior to FIGO stage for evaluating the parametrium, pelvic wall invasion and dis-tant metastasis. The extent of tumor volume shrinkage was more than 90%in all the patientsSix months after radiother-apy. Among them, seventeen patients were complete response. The complete response of radiotherapy were usually presented as hypotense signal at T2WI, SPIR MR imaging and slight or no enhancement at GD-DTPA T1WI images. Conclusion MR imaging can show the local tumors and extension of the cervical carcinoma, it is superior to clinical evaluation in the staging. MR imaging is helpful in evaluating cervical carcinoma response to radiotherapy.