摘要
目的:评估宫颈癌放化疗应用磁共振弥散加权成像(DWI)进行早期评估的作用效果。方法:选择本院经手术或宫颈病理活检诊断确诊的60例宫颈癌患者作为观察组,选择同期接受检查的非盆腔疾病患者60例作为对照组,术前开展磁共振成像(MRI)与DWI检查,比较两组检查时表现扩散系数(ADC)在不同病理与疗效时的数值差异变化。结果:对照组开展DWI检查显示,T1WI为均匀等信号,T2WI为多层样改变,宫颈管内黏液呈高信号,宫颈黏膜皱襞与子宫肌外层为中等信号,宫颈纤维基质为低信号;宫颈管内膜ADC值为(1.35±0.17)×10^(-3)mm^(2)/s,结合带ADC值为(1.54±0.15)×10^(-3)mm^(2)/s,肌层ADC值为(2.02±0.22)×10^(-3)mm^(2)/s。观察组宫颈癌患者的T1WI为等信号,T2WI呈均匀或混杂稍高信号影,DWI呈高信号,平均ADC值为(0.95±0.13)×10^(-3)mm^(2)/s,与对照组正常宫颈平均ADC相比更低,有统计差异(P<0.05)。宫颈鳞癌的ADC值(0.89±0.12)×10^(-3)mm^(2)/s与腺癌ADC值(1.04±0.09)×10^(-3)mm^(2)/s相比有明显统计差异(P<0.05)。相比于化疗前ADC值(0.95±0.13)×10^(-3)mm^(2)/s,化疗4周后的ADC值(1.49±0.08)×10^(-3)mm^(2)/s明显升高,有统计差异(P<0.05)。结论:DWI可有效诊断宫颈癌,可根据ADC值区分宫颈癌的病理学类型,也可根据ADC值变化情况了解放化疗前后的治疗效果。
Objective:To evaluate the effect of diffusion weighted magnetic resonance imaging(DWI)on early evaluation of radiotherapy and chemotherapy for cervical cancer.Methods:Our hospital diagnosed by surgery or pathology biopsy in the diagnosis of cervical 60 cases of cervical cancer patients as observation group,choose the same period for inspection of 60 cases as control group patients with pelvic disease,preoperative magnetic resonance imaging(MRI)and DWI examination,can compare the two sets of inspection performed diffusion coefficient(ADC)in different pathological change and curative effect of numerical difference.Results:In the control group,DWI showed homogeneous signal on T1WI,multilayer signal on T2WI,high signal on cervical mucus,medium signal on cervical mucosal folds and uterine muscle outer layer,and low signal on cervical fibrous matrix.The ADC values of the endometrial cervical canal were(1.35±0.17)×10^(-3)mm^(2)/s,the ADC values of the binding band were(1.54±0.15)×10^(-3)mm^(2)/s,and the ADC values of the muscular layer were(2.02±0.22)×10^(-3)mm^(2)/s.The T1WI of patients with cervical cancer in the observation group showed isosignal,T2WI showed uniform or mixed slightly high signal shadow,DWI showed high signal,and the average ADC value was(0.95±0.13)×10^(-3)mm^(2)/s,which was lower than the average ADC of normal cervical cancer in the control group,with statistical difference(P<0.05).The ADC value of cervical squamous carcinoma(0.89±0.12)×10^(-3)mm^(2)/s was significantly different from that of adenocarcinoma(1.04±0.09)×10^(-3)mm^(2)/s(P<0.05).Compared with the ADC value before chemotherapy(0.95±0.13)×10^(-3)mm^(2)/s,the ADC value after 4 weeks of chemotherapy(1.49±0.08)×10^(-3)mm^(2)/s was significantly higher than that before chemotherapy(P<0.05).Conclusion:DWI can effectively diagnose cervical cancer,distinguish the pathological type of cervical cancer according to ADC value,and understand the therapeutic effect before and after radiotherapy and chemotherapy according to the change of ADC value.
作者
岳美淋
周作福
章国伟
杨青霞
刘朝禄
YUE Mei-lin;ZHOU Zuo-fu;ZHANG Guo-wei;YANG Qing-xia;LIU Chao-lu(Imaging Department of Fujian Maternal and Child Health Hospital,Fujian Fuzhou 350001)
出处
《中国医疗器械信息》
2022年第16期65-67,共3页
China Medical Device Information
关键词
宫颈癌
放疗
化疗
磁共振弥散加权成像
cervical cancer
radiation therapy
chemotherapy
magnetic resonance diffusion weighted imaging
