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目的:探讨磁共振弥散加权成像(DWI)在预测宫颈癌患者早期放化疗效果及预后的应用价值。方法:选择2011年2月~2014年2月在我院住院并接受同期放化疗的宫颈癌患者共74例,于放化疗前、放化疗中、放化疗结束时进行磁共振(MR)扫描及DWI检查。记录不同时间段的肿瘤体积和宫颈癌表观弥散系数(ADC)变化,依据实体瘤的疗效评价标准(RECIST)标准比较放化疗前后不同疗效组ADC值及其变化率。对患者进行18个月的随访,以病理切片检查结果为金标准,分析DWI对宫颈癌复发诊断的灵敏度和特异度。结果:放化疗前、中、结束时患者的肿瘤体积和ADC值差异具有统计学意义(P<0.05);与放化疗前相比,不同疗效组放化疗后的ADC值均明显升高(P<0.05),且放化疗后各组ADC值和ADC变化率之间差异均具有统计学意义(P<0.05);DWI对宫颈癌复发诊断的灵敏度和特异度分别为95.83%和95.45%。结论:DWI可以预测宫颈癌早期放化疗临床疗效,并对患者预后评估具有较高的灵敏度和特异度,值得在临床上广泛推广。
Objective: To investigate the value of diffusion weighted imaging (DWI) in predicting the effect of early chemoradiotherapy and prognosis of patients with cervical cancer. Methods: A total of 74 patients with cervical cancer admitted to our hospital from February 2011 to February 2014 were enrolled in this study. Before radiotherapy and chemotherapy, radiotherapy and chemotherapy, MR imaging was performed at the end of radiotherapy and chemotherapy and DWI check. The changes of tumor volume and apparent diffusion coefficient (ADC) of cervical cancer at different time points were recorded. The ADC value and its rate of change in different curative effect groups before and after radiotherapy and chemotherapy were compared according to RECIST criterion. The patients were followed up for 18 months to analyze the sensitivity and specificity of DWI in the diagnosis of cervical cancer recurrence based on the biopsy results. Results: There was a significant difference in tumor volume and ADC value before, during and after radiotherapy and chemotherapy (P <0.05). Compared with those before radiotherapy and chemotherapy, the ADC values of radiotherapy and chemotherapy group were significantly increased (P <0.05). The differences of ADC value and ADC between radiotherapy and chemotherapy were statistically significant (P <0.05). The sensitivity and specificity of DWI for diagnosis of recurrence of cervical cancer were 95.83% and 95.45% respectively. Conclusion: DWI can predict the curative effect of early radiotherapy and chemotherapy of cervical cancer, and has high sensitivity and specificity for the prognosis evaluation of patients with cervical cancer. It is worth widely popularized in clinic.