摘要
目的分析高场强磁共振结合弥散成像技术对进展期宫颈癌化疗效果的评价价值。方法选取该院进行治疗的子宫颈原位癌患者20例、子宫颈进展癌患者80例、体检的健康患者20例的临床资料进行回顾性分析,对比正常宫颈与各类型肿瘤表观扩散系数(ADC)值,比较化疗宫颈鳞癌患者与宫颈腺癌患者扩散敏感梯度b=800mm2/s及b=2 000mm2/s时的ADC平均值,统计不同预后患者的ADC值及变化率,并对比化疗不同时段患者ADC值与肿瘤体积变化情况。结果子宫颈进展癌患者的ADC值低于正常体检者及子宫颈原位癌患者,差异有统计学意义(P<0.05)。化疗前,不同b值检测宫颈腺癌患者的ADC平均值均明显高于宫颈鳞癌患者,差异有统计学意义(P<0.05);化疗后,不同b值检测宫颈腺癌患者的ADC平均值均明显高于宫颈鳞癌患者,差异有统计学意义(P<0.05)。化疗前不同疗效患者的ADC值比较,差异无统计学意义(P>0.05);化疗后,可见全部缓解(CP)患者ADC值最高为(1.830 4±0.214 7)×10-3 mm2/s,其次为部分缓解(PR)患者为(1.502 5±0.187 5)×10-3 mm2/s,疾病稳定(SD)患者相对较低为(1.401 7±0.157 6)×10-3 mm2/s,疾病进展(PD)患者ADC值最低为(1.387 9±0.166 1)×10-3 mm2/s。不同化疗预后患者ADC变化率以CP最大,其次为预后PR和预后SD患者,预后为PD患者ADC变化率最小,差异有统计学意义(P<0.05)。化疗前患者ADC值为(0.988 7±0.182 6)×10-3 mm2/s,化疗2个疗程后为(1.225 4±0.221 4)×10-3 mm2/s,化疗结束后为(1.658 7±0.244 3)×10-3 mm2/s,ADC平均值呈现出升高趋势,差异有统计学意义(P<0.05)。随着化疗疗程增加,患者肿瘤体积也呈现出逐渐减小的趋势,差异有统计学意义(P<0.05)。结论高场强磁共振结合弥散成像可辅助判定宫颈癌病变程度,预测进展期宫颈癌化疗效果,准确性高,可广泛应用于临床宫颈癌化疗。
Objective To evaluate the value of high field magnetic resonance combined with diffusion imaging in evaluating the efficacy of chemotherapy in advanced cervical cancer.Methods Twenty patients with cervical cancer were selected for treatment in our hospital,and 80 cases of cervical cancer,clinical data of 20 patients with physical examination were retrospectively analyzed.Comparison of normal cervix and various types of tumor cervical endometrial ADC value,and comparison of chemotherapy in patients with cervical squamous cell carcinoma and cervical adenocarcinoma b value=800 mm2/s and b=2 000 mm2/s when the ADC average.The ADC value and the change rate of patients with different prognosis were calculated and the ADC value and tumor volume were changed in different time.Results Cervical progress in patients with ADC values lower than the normal physical examination and cervical cancer in situ,there was a significant difference（P〈0.05）.The mean ADC scores of cervical adenocarcinoma were significantly higher than those of cervical squamous cell carcinoma（P〈0.05）,and the difference was statistically significant（P〈0.05）.After chemotherapy,the ADC scores of patients with cervical adenocarcinoma were significantly higher than those of cervical squamous cell carcinoma（P〈0.05）.There was no significant difference in ADC value between different patients before chemotherapy（P〈0.05）.After chemotherapy,the highest ADC value of CP patients was（1.830 4±0.214 7）×10-3 mm2/s,followed by PR patients with（1.502 5±0.187 5）×10-3 mm2/s,SD patients were relatively low（1.401 7±0.157 6）×10-3 mm2/s,PD patients with the lowest ADC value of（1.387 9±0.166 1）×10-3 mm2/s.The change rate of ADC in patients with different prognosis was the highest in CP,followed by prognosis PR and prognosis.The prognosis was the smallest ADC change rate（P〈0.05）.The ADC value was（0.988 7±0.182 6）×10-3 mm2/s before chemotherapy,（1.225 4±0.221 4）×10-3 mm2/s after 2 courses of chemotherapy,（1.65
作者
王艳
康嗣如
田荣华
WANG Yan;KANG Siru;TIAN Ronghua(MRI Room,Xiaogan Center Hospital,Xiaogan,Hubei 432000,China)
出处
《检验医学与临床》
CAS
2018年第18期2715-2718,2721,共5页
Laboratory Medicine and Clinic
关键词
宫颈癌
高场强磁共振
弥散成像技术
化疗
预后
cervical cancer
high field magnetic resonance
diffusion imaging
chemotherapy
prognosis
