宫颈癌中子刀(252锎)放射治疗前后MRI检查的临床价值_临床医学论文.docVIP

宫颈癌中子刀(252锎)放射治疗前后MRI检查的临床价值_临床医学论文 宫颈癌中子刀(252锎)放射治疗前后MRI检查的临床价值_临床医学论文 作者：张殿波 荣荥 王旭东 徐兵 宋万江 戴志学 【摘要】 目的 分析宫颈癌中子刀(252锎)放射治疗前后的MRI表现，探讨MRI对宫颈癌中子刀(252锎)放射治疗后的诊断价值。 方法 对100例经病理证实的宫颈癌患者在中子刀(252锎)放射治疗前及放疗后不同时间段行MRI扫描。每次MRI扫描均用相同的扫描方法。在MRI图像上观察肿瘤中子刀(252锎)放射治疗前后的大小、信号改变及其周围结构的变化，进行对比分析。 结果 放疗结束时，局部控制率100%;78例肿瘤消失;22例肿瘤明显缩小，缩小率gt;85%。肿瘤信号改变：放疗结束后，78例肿瘤信号消失，T2WI及STIR无异常信号改变，22例T2WI及STIR见有肿瘤信号;T1WI增强，78例无异常信号改变或轻微强化，22例不均匀强化;放疗后2年内，97例无异常信号改变;T1WI增强成像后，90例无异常信号改变，3例轻微强化。7例T2WI及STIR仍见有不均匀肿瘤信号，但较前期信号明显降低，T1WI增强，肿瘤呈不均匀强化。放疗后盆腔内脏器的表现：并发直肠炎性改变5例，肠壁增厚(6mm~-9.5mm)，T1WI呈等信号，T2WI及STIR呈高信号;膀胱炎性改变3例，膀胱壁增厚(6.2mm)，T1WI呈等信号，T2WI及STIR呈高信号;子宫颈限局性改变3例，T1WI呈低信号，T2WI及STIR呈高信号。放疗后2年内，上述改变恢复正常或轻微纤维化。 结论 MRI检查可反映中子刀(252锎)对肿瘤的疗效，是评价宫颈癌中子刀(252锎)放射治疗疗效及预后的最佳检查手段。放疗结束后，肿瘤缩小程度、T2WI上的信号改变及T1WI增强扫描瘤内有无强化区是预测中子刀(252锎)放射治疗效果的重要观测指标。 【关键词】 子宫颈癌;中子刀(252锎);　放射治疗;磁共振成像 Clinical value in evaluating of cervical cancer to neutron-knife radiation therapyZHANG Dianbo, RONG Xing, WANG Xu-dong, et al. Department of MRI, the Hospital of Heilongjiang Farm , Harbin China[Abstract] Objective To analysis the image of MRI and discuss 0the diagnostic value of MRI in evaluating of cervical cancer to neutron-knife radiation therapy . Methods 100cases were checked by MRI before and after radiation therapy that were confirmed by pathology with cervical cancer . Same scan methods were done . We compared and discussed the changing of image in size , signal and surrounding of tumor befor and after neutron-knife radiation therapy . Results At the end of radiation therapy , rate of partial control was 100% . Among them ,tumors was disappear in 78 cases ,tumors got smaller obviously in 22 cases ,small rate was more than 85% . Signal changing of tumors : At the end of radiation therapy , signal were disappear in 78 cases , no abnormal signal changing were seen at T2WI and STIR . Tumors signal were seen in 22 cases . In T1WI enhancement , no signal changing or slight enhancement were in 78 cases , uneven enhancement were in 22 cases