【摘要】 目的:探讨晚期宫颈癌患者新辅助化疗前后局部磁共振灌注成像(MR-PWI)的改变是否与实体瘤客观疗效标准(RECIST)标准判断一致。方法:对31例经病理确诊的宫颈癌患者依据RECIST标准判断,分为化疗有反应组和无反应组,分别在行新辅助化疗前和两次化疗(5周)后进行MR灌注扫描,观察病灶的形态和灌注表现,绘制感兴趣区,获得时间-信号强度曲线(TIC)和病灶相对强化百分比(percentage of relative enhancement,PRE)和最大强化百分比(percentage of maximum enhancement,PME),曲线下面积(area under the curve,AUC),使用统计软件分析比较化疗前后肿瘤灌注值改变。结果:依据RECIST标准判断31例中,有反应组24例(23例部分缓解,1例完全缓解),无反应组7例(5例稳定,2例进展),共收集到24例肿瘤反应组病例,追踪到其手术根治,MR PWI观察到有反应组化疗前肿瘤PRE和PME分别为(228.54±61.83)和(2 405.61±758.29),化疗后肿瘤分别为(142.85±43.26)和(1 659.18±597.37),差异有统计学意义(P<0.05);有反应组肿瘤AUC化疗前为(291 323.70±10 956.80),化疗后为(168 952.8±67 214.02),差异有统计学意义(P<0.05)。无反应组化疗前肿瘤PRE和PME分别为(175.65±10.43)和(2 085.31±133.12),化疗后为(164.92±24.43)和(2 224.18±209.95),差异无统计学意义(P>0.05);无反应组化疗前肿瘤AUC为(241 469.28±14 517.16),化疗后肿瘤AUC为(262 993.85±27 119.08),差异无统计学意义(P>0.05)。结论:MR-PWI改变与RECIST标准判断相符合,可作为常规影像评价的补充方法。更多还原

【Abstract】 Aim:To study tumour response of local advanced cervical cancer for neoadjunt chemotherapy before and after neoadjunt chemotherapy with MR perfusion,discuss the perfusion value Whether or not consistent with the RECIST standard judgment result.Methods:Thirty-one cases of pathologically di-agnosed cervical carcinoma patients were carried out MR perfusion scanning before and after two times of the neoadjuvant chemotherapy,using 3.OT MR scanner.The followings were observed:lesion morphology and perfusion performance,including time-signal intensity curve(TIC),percentage of relative enhancement(PRE),percentage of maximum enhancement(PME) and area under the curve(AUC).The statistical software SPSS 17.0 was used to compare tumor perfusion values before and after neoadjuvant chemotherapy.Results;According to the RECIST standard,31 cases were classified as the effective group(including complete response 1 case and partial response 23 cases) and the ineffective group(including two cases progressive and 5 cases stable disease).In the effective group,tumor PRE and PME were(228.54 ±61.83) and(2 405.61 ±758.29) before chemotherapy,(142.85 ±43.26) and(1 659.18 ±597.37) after chemotherapy,respectively.The difference was statistically in significant(both P <0.05);tumor AUC was(291 323.70 ± 10 956.80) before chemotherapy,(168 952.8 ± 67 214.02) after chemotherapy,respectively,the difference was statistically significant(P <0.05).In the ineffective group tumor PRE and PME were(175.65 ± 10.43) and(2 085.31 ± 133.12) before chemotherapy,(164.92 ±24.43) and(2 224.18 ±209.95) after chemotherapy,respectively.The difference was statistically significant(both P >0.05);tumor AUC was(241 469.28 ± 14 517.16) before chemotherapy,(262 993.85 ±27 119.08) after chemotherapy,respectively,the difference was statistically in significant(P > 0.05).Conclusion;the values of Magnetic resonance perfusion imaging were Consistent with the RECIST standard judgment result,MRPWI can more accurately and objectively reflect the cervical cancer after neoadjuvant chemotherapy of tumor response,as the RECIST criteria to select an auxiliary functional magnetic resonance imaging.更多还原