摘要
目的 分析宫颈癌放射治疗 (简称放疗 )中与放疗后肿瘤与盆部非肿瘤组织、器官的MRI改变。方法 4 8例经病理证实的宫颈癌患者在放射治疗前、治疗中和治疗后不同时间段行盆腔的MR成像。在MR图像上观察肿瘤及盆部软组织、器官及骨髓在放疗前后的大小或信号改变。结果 (1)放疗中 ,4例肿瘤无缩小 ,4 2例肿瘤出现不同程度缩小 ,2例肿瘤消失。T1W增强成像 ,15例患者肿瘤灶内出现“无强化区”。肿瘤痊愈表现为T2 W、频率敏感脂肪抑制 (SPIR)序列成像呈低信号 ,T1W增强扫描轻微强化或无强化。 (2 )放疗可引起盆腔区域多个软组织、器官的异常MRI表现。 (3)骨髓信号最早出现改变的是在外照射开始后第 8天 ,病人受照剂量在 12Gy时。放疗早期 ,骨髓在T1W、T2 W及SPIR序列影像上信号升高 ,T1W增强扫描见强化。放疗晚期 ,骨髓的T1WI、T2 WI上信号升高程度增加 ,SPIR序列图像上出现信号降低 ,T1W增强扫描骨髓强化不明显。结论MR成像有助于宫颈癌放疗疗效的评价 ,同时可显示放射线所致的盆部软组织器官及骨髓的损伤。
Objective To study the radiation-induced changes of carcinoma lesion and non-tumor tissues and organs of pelvis in patients with cervical cancer on magnetic resonance (MR) imaging during and after radiation therapy (RT). Methods Pelvic MR imaging was performed in 48 patients with cervical carcinoma before,during,and after radiation therapy.The size and signal changes of carcinoma lesions and pelvic soft tissues and bone marrow were observed on MR images.Results (1) During RT,tumor volume showed no changes in 4 patients,shrinkage in 42 patients,and disappearance in 2 patients.“No enhanced area” in carcinoma lesion was observed in 15 patients on Gd-DTPA enhanced T_1WI.Tumor complete response to radiation therapy showed hypointense signal on T_2WI and SPIR MR image and slight or no enhancement on Gd-DTPA T_1WI.(2) Abnormality was detected in multiple tissues and organs on MR imaging after RT.(3) Radiation-induced bone marrow signal changes were detected as early as 8 days after the initiation of external beam radiotherapy (EBRT) when the radiation dose reached 12 Gy.Acute changes of bone marrow could be demonstrated as increased signal intensity (SI) on T_1-weighted,T_2-weighted,and SPIR images,and enhanced SI on contrasted T_1-weighted images.During the chronic phase of RT,SI of bone marrow showed steady and marked increase on T_1-weighted and T_2-weighted images,and decrease on SPIR sequence in some patients,and no enhanced SI on contrasted T_1-weighted images. Conclusion MR imaging is helpful in the evaluation of cervical carcinoma response to radiation therapy,and can detect radiation-induced changes of soft tissue and bone marrow of pelvis during and after RT.
出处
《中华放射学杂志》
CAS
CSCD
北大核心
2004年第7期721-725,共5页
Chinese Journal of Radiology
基金
广东省医学科研课题资助项目 (A2 0 0 15 60 )
关键词
宫颈癌
放疗
盆腔
MRI
评价
放射治疗剂量
Cervix neoplasms
Radiotherapy dosage
Magnetic resonance imaging
Evaluation studies
