本文選題：宮頸癌 + 介入栓塞�。� 參考：《寧夏醫(yī)科大學》2014年碩士論文

【摘要】：目的通過檢測宮頸癌介入栓塞治療前后磁共振彌散加權成像（DWI）表觀擴散系數(shù)（ADC）值的變化情況，分析腫瘤范圍內(nèi)病灶突出部位的ADC值及其變化率與術后腫瘤大小的關系，從而探討磁共振DWI在宮頸癌介入栓塞術后早期療效評價中的應用，尋求預測及監(jiān)測腫瘤療效的最佳時間點。 方法篩選44例采用介入栓塞治療的宮頸癌確診病例，于術前及術后第2天、5天、10天及15天行常規(guī)T2加權成像（T2WI）及彌散加權成像（DWI）檢查，b值選700和1500s/mm2，每次檢查均測量腫瘤大小、腫瘤及正常臀大肌ADC值。觀察每個監(jiān)測時間點腫瘤大小與不同b值的ADC值和ADC值變化率之間的關系。 結果b=700s/mm2時介入栓塞術前及術后第2天、5天、10天及15天腫瘤ADC值依次為0.97±0.11、1.07±0.18、1.24±0.13、1.35±0.12、1.41±1.17×10-3mm2/s，其中術后第15天測得病灶ADC值與第10天相比差異無統(tǒng)計學意義（p=0.122），其余各相鄰時間點間差異均有統(tǒng)計學意義（P0.05）；b=1500s/mm2時ADC值依次為0.79±0.09、0.84±0.15、0.95±0.13、1.04±0.16、1.14±0.17×10-3mm2/s，，各相鄰時間點間差異均有統(tǒng)計學意義（P0.05）。臀大肌不同b值下ADC值不同時間點間差異均無統(tǒng)計學意義（P0.05）。術前及術后各時間點腫瘤長徑大小依次為3.86±1.15、3.36±1.12、2.94±1.12、2.45±1.08、2.25±1.00cm，術后不同時間點與術前腫瘤長徑大小相比變化率為12.95%、24.54%、37.32%、43.27%。其中術后第10天及第15天腫瘤長徑大小和其變化率之間無統(tǒng)計學差異，其余各相鄰時間點間差異均有統(tǒng)計學意義（P0.05）。當b=1500時術后第10天腫瘤ADC值及其變化率與術后第5天、10天及15天的腫瘤長徑大小均存在線性相關（P0.05），其中第10天腫瘤ADC值變化率與第15天腫瘤長徑間關系程度最強（p=0.001，r=-0.726）。 結論介入栓塞治療對宮頸癌患者具有明顯療效，DWI具有評價宮頸癌介入栓塞術后療效觀察與判定的潛在價值，通過對ADC值的觀察初步發(fā)現(xiàn)術后第10天復查磁共振臨床價值最大，可以做為評價早期療效的最佳監(jiān)測點。
[Abstract]:Objective to investigate the changes of apparent diffusion coefficient (ADC) of diffusion weighted Mr imaging (DWI) before and after interventional embolization of cervical cancer, and to analyze the relationship between the ADC value and the postoperative tumor size.The purpose of this study was to explore the application of magnetic resonance (DWI) in the evaluation of early curative effect after interventional embolization of cervical cancer, and to find the best time point to predict and monitor the curative effect of cervical cancer.Methods 44 cases of cervical cancer diagnosed by interventional embolization were selected. T2WI and DWI were performed before and after operation. The tumor size was measured by T2-weighted T2WI and DWI. The tumor size was measured at each time.ADC of tumor and normal gluteus maximus muscle.The relationship between tumor size and ADC value and ADC value of different b value at each monitoring time point was observed.Results the ADC values were 0.97 鹵0.111.07 鹵0.181.24 鹵0.131.35 鹵0.121.41 鹵1.17 脳 10 ~ (-3) mm ~ (-2) / s before and on the second day after b=700s/mm2, respectively. There was no significant difference in ADC between the 15th day and the 10th day after b=700s/mm2, and there was no significant difference between the other adjacent time points.The ADC values were 0.79 鹵0.09 鹵0.84 鹵0.15 ~ 0.95 鹵0.13 鹵1.04 鹵0.16 鹵1.14 鹵0.17 脳 10 ~ (-3) mm ~ 2 路s ~ (-2 / s) respectively. There were significant differences among the adjacent time points (P < 0.05).There was no significant difference in ADC value between different time points under different b value of gluteus maximus muscle (P 0.05).The size of tumor long diameter was 3.86 鹵1.15t 3.36 鹵1.12C 2.94 鹵1.12C 2.45 鹵1.08U 2.25 鹵1.00 cm before and after operation, and the change rate was 12.95 ~ 24.54 ~ 37.32 ~ 37.32 鹵43.27 cm at different time points after operation.There was no statistical difference between the tumor length and the rate of change on the 10th and 15th day after operation, but there was significant difference between the other adjacent time points (P 0.05).There was a linear correlation between the tumor ADC value and the tumor length on the 5th and 15th day after operation, and the relationship between the ADC value on the 10th day and the tumor length diameter on the 15th day was the strongest.Conclusion the interventional embolization therapy has obvious curative effect on cervical cancer patients. DWI has potential value in evaluating the curative effect of cervical cancer after interventional embolization. The clinical value of magnetic resonance imaging is the most significant on the 10th day after operation through the observation of ADC value.It can be used as the best monitoring point to evaluate the early curative effect.
【學位授予單位】：寧夏醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2014
【分類號】：R445.2;R737.33

【參考文獻】

相關期刊論文 前5條

1 劉洪超;王勝裕;王晨光;于紅;葉曉丹;毛新峰;劉士遠;;炎性和轉移性淋巴結彌散加權成像b值選擇的初探[J];中國CT和MRI雜志;2012年02期

2 詹雪梅;楊愛蓮;房昭;魏繼紅;;兩種新輔助化療治療Ⅱ_B期宮頸癌近期療效的比較[J];現(xiàn)代腫瘤醫(yī)學;2008年09期

3 馬玉英;王偉;陳素瓊;;宮頸癌新輔助化療54例臨床分析[J];現(xiàn)代腫瘤醫(yī)學;2009年09期

4 劉萍;陳春林;曾北藍;馬奔;張浩;;宮頸癌術前動脈化療的組織病理學動態(tài)變化及臨床結局[J];中國實用婦科與產(chǎn)科雜志;2006年02期

5 魏敏;楊永秀;楊愛宏;劉暢;白雪飛;;順鉑對人宮頸癌SiHa細胞中TSLC1基因表達的影響[J];中國婦幼保健;2013年08期

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