何长久,任静,许国辉,后军民,王闽,庞华容,董晓蕾,何雅坤,李海烈.磁共振扩散加权成像预测与评价宫颈癌放化疗疗效的研究[J].中华放射医学与防护杂志,2014,34(11):841-844
磁共振扩散加权成像预测与评价宫颈癌放化疗疗效的研究
Study on predicting and evaluating the effect of chemo-radiation therapy in cervical cancer by diffusion-weighted magnetic resonance imaging
投稿时间:2014-05-12  
DOI:10.3760/cma.j.issn.0254-5098.2014.11.010
中文关键词:  扩散加权成像  宫颈癌  放化疗  预测  评价
英文关键词:DWI  Cervical cancer  Chemo-radiation therapy  Prediction  Evaluation
基金项目:
作者单位E-mail
何长久 成都四川省肿瘤医院影像科, 成都 610041  
任静 成都四川省肿瘤医院影像科, 成都 610041  
许国辉 成都四川省肿瘤医院影像科, 成都 610041 XGH0913@hotmail.com 
后军民 成都四川省肿瘤医院影像科, 成都 610041  
王闽 成都四川省肿瘤医院影像科, 成都 610041  
庞华容 成都四川省肿瘤医院影像科, 成都 610041  
董晓蕾 成都四川省肿瘤医院影像科, 成都 610041  
何雅坤 成都四川省肿瘤医院影像科, 成都 610041  
李海烈 成都四川省肿瘤医院影像科, 成都 610041  
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中文摘要:
      目的 探讨磁共振扩散加权成像(DWI)在预测与评价宫颈癌放化疗疗效中的应用价值.方法 收集282例经病理检查证实为宫颈癌的患者,分别在治疗前、治疗结束后行DWI检查,测量肿瘤最大径和表现扩散系数(ADC)值.治疗结束后,依据实体肿瘤疗效评价标准(RECIST)将患者分为缓解组、无效组.根据治疗结束后2年的随访复查情况将患者分为复发组、无复发组.比较两组间的治疗前和治疗结束后ADC值,并分析疗效及复发情况与治疗前ADC值、治疗结束后的ADC升高值之间的相关性. 结果 缓解组223例,无效组59例.复发组70例,无复发组212例.缓解组治疗前ADC值明显低于无效组(t=3.274,P<0.05),无复发组治疗前ADC值明显低于复发组(t=1.031,P<0.05).治疗前ADC值低的患者复发率明显低于治疗前ADC值高的患者(χ2=5.175,P<0.05).治疗结束后的疗效及治疗结束后2年的复发情况与治疗前ADC值均呈负相关(r=-0.571、-0.675,P<0.05),与治疗结束后的ADC升高值均呈正相关(r=0.641、0.547,P<0.05).缓解组、无复发组治疗结束后ADC值升高明显(t=2.031、4.011,P<0.05),无效组、复发组ADC值升高不明显.结论 治疗前的ADC值有助于预测宫颈癌放化疗疗效,治疗结束后的ADC变化值有助于评价宫颈癌放化疗疗效.
英文摘要:
      Objective To investigate the value in application of diffusion-weighted magnetic resonance imaging on predicting and evaluating the efficacy of chemo-radiation therapy in cervical cancer.Methods To tally 282 patients with cervical cancer diagnosed by pathological examination were examined before and after treatments using DWI, while the ADC values and the max diameters were measured. The patients were divided into ease and invalid group on the basis of Response Evaluation Criteria In Solid Tumors (RECIST)after treatments, and divided into recurrence and non recurrence group according to 2- year follow-ups after treatments. The ADC value before and after treatment between the two groups were compared respectively, and correlation test was performed. Results The patients were divided into ease group (223 cases) and invalid group (59 cases), recurrence group (70 cases) and non recurrence group (212 cases). The ADC values of ease group were significantly lower than invalid group before treatments(t=3.274,P<0.05),which of non recurrence group were significantly lower than recurrence group before treatments(t=1.031,P<0.05). The recurrence rates of patients with low ADC values before treatments were significantly lower than the patients with high ADC values before treatments(χ2=5.175,P<0.05).The efficacy after treatment for 2 months and follow-ups after treatment for 2 years were both negative correlated with the ADC value before treatment(r=-0.571, -0.675,P<0.05), and positively correlated with the elevated ADC value after treatment(r=0.641, 0.547,P<0.05).The ADC values after treatments of ease group and non recurrence group increased significantly (t=2.031, 4.011, P<0.05), however, invalid group and the recurrence group increased insignificantly. Conclusions The ADC value before treatment can be used to predict curative effect of chemo-radiation therapy in cervical cancer, while the changes of ADC value after treatment are able to evaluate the efficacy of the treatment.
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