CAJ | 학술논문

目的：观察宫颈癌根治术后复发的患者扩散加权成像（ DWI）特点及其与放化疗反应之间的关系。方法以26例宫颈癌根治术后复发患者为研究对象，在放化疗前后进行常规磁共振扫描和DWI检查。记录肿瘤的基线特点包括复发部位、大体肿瘤体积、坏死区和ADC值，勾画扩散受限局灶作为一个单独的ROI并测量ADC值。按完全反应（ CR组）、部分反应（ PR组）分组，比较组间的影像学特点。结果12例为CR组，14例为PR组。部分反应患者放化疗后的ADC值显著高于放化疗前的ADC值。与CR组相比，PR组患者具有更大的大体肿瘤体积、更高的ADC值和更多的扩散受限局灶，而复发类型、坏死区域未见显著差异。结论应用DWI获得的ADC值和扩散受限局灶有助于判断宫颈癌复发癌灶对放化疗的反应，这有助于临床医师早期预测治疗效果，对于合理制定方案、提高治疗效果具有重要意义。
목적：관찰궁경암근치술후복발적환자확산가권성상（ DWI）특점급기여방화료반응지간적관계。방법이26례궁경암근치술후복발환자위연구대상，재방화료전후진행상규자공진소묘화DWI검사。기록종류적기선특점포괄복발부위、대체종류체적、배사구화ADC치，구화확산수한국조작위일개단독적ROI병측량ADC치。안완전반응（ CR조）、부분반응（ PR조）분조，비교조간적영상학특점。결과12례위CR조，14례위PR조。부분반응환자방화료후적ADC치현저고우방화료전적ADC치。여CR조상비，PR조환자구유경대적대체종류체적、경고적ADC치화경다적확산수한국조，이복발류형、배사구역미견현저차이。결론응용DWI획득적ADC치화확산수한국조유조우판단궁경암복발암조대방화료적반응，저유조우림상의사조기예측치료효과，대우합리제정방안、제고치료효과구유중요의의。
Objective To observe the relationship between diffusion-weighted imaging ( DWI) characteristics and chemoradiotherapy response in recurrence patients with radical hysterectomy .Methods 26 recurrence patients with radical hysterectomy were included .All underwent conventional MRI and DWI before and after chemoradiotherapy . Baseline tumor characteristics including recurrence site ,gross tumor volume ,necrotic area and the ADC value were re-corded.Focal regions of restricted diffusion were delineated as a separate ROI and ADC value was determined .Ima-ging features were compared between complete response group and partial response group .Results 12 patients had complete response ( CR group ) ,14 patients had partial response ( PR group ) .ADC valueafter chemoradiotherapy was significantly higher than that before chemoradiotherapy in PR patients .Compared with CR group ,PR group had a grea-ter gross tumor volume ,higher ADC value and more focal regions of restricted diffusion .Recurrence type and necrotic areas was no significant differences .Conclusion ADC value and focal regions of restricted diffusion adquired by DWI help to determine chemoradiotherapy response in recurrence patients with radical hysterectomy ,which is helpful for clinicians to predic treatment effect early .It has great significance for developing reasonable programs and impro-ving the therapeutic effect .