The Curative Effect Evaluation Of 3.0 TMRI Diffusion Weighted Imaging(DWI)in Combination With Dynamic Contrast Enhancement(DCE)on Cervical Cancer Radiotherapy

Purpose: Discuss the evaluation value of diffusion weighted imaging(DWI)and dynamic contrast enhancement(DCE)on cervical cancer radiotherapy curative effect.Methods: Implement conventional MR scan,DWI,and DCE on 40 patients who are pathologically diagnosed as cervical cancer before treatment and one month,three to six months after treatment respectively,measure ADC value and drawing time signal intensity curve(TIC)of CR group and PR group at each period of tumor before and after treatment respectively.According to evaluation criteria in solid tumors(RECIST),it is divided into complete remission(CR)group and part remission(PR).ADC value and maximum relative signal enhancement rate(MRE%)difference of each curative effect group before and after treatment are analyzed.Results: Cervical cancer presented obvious high signal on DWI before treatment,and the dynamic curve presented many reinforcement ways including prompt rise and prompt drop,prompt rise platform,slow rise platform,and continuous rise.One month after treatment,the tumor signal reduced on both DWI and DCE;three to six months after treatment,it presented equisignal on DWI of CR group,DCE intensifying degree reduced significantly or it was not intensified,and moreover,it presented slight high signal on DWI and DCE of PR group.? One month after radiotherapy of CR group,cervical cancer nidus ADC value(0.850±0.066×10-3 mm2/s)rose comparing with that before radiotherapy(0.664±0.089×10-3 mm2/s),with no statistical significance for the difference(P>0.05);one month after radiotherapy of PR group,cervical cancer nidus ADC value(0.830±0.071×10-3 mm2/s)rose comparing with that before radiotherapy(0.701±0.088×10-3 mm2/s),with no statistical significance for the difference(P>0.05);? One month after radiotherapy of CR group,cervical cancer nidus MRE value(183.26±70.36)rose comparing with that before radiotherapy(211.12±63.68),with no statistical significance for the difference(P<0.05);one month after radiotherapy of PR group,cervical cancer nidus MRE value(199.67±54.42)rose comparing with that before radiotherapy(213.65±48.96),with no statistical significance for the difference(P<0.05);?Three to six months after radiotherapy,ADC value of both CR group and PR group rose significantly,being(1.210±0.081×10-3 mm2/s)and(1.031±0.051×10-3 mm2/s)respectively,and there was statistical significance when comparing with ADC value of one month before and after radiotherapy(P<0.05);three to six months after radiotherapy,MRE value of CR group and PR group reduced significantly,being(134.74±61.85)and(142.23±49.24)respectively,which had statistical significance when comparing with MRE value of one month before and after radiotherapy(P<0.05).ADC value rose and MRE value reduced after tumor radiotherapy,and moreover,rangeability of ADC value and MRE value of CR group before and after radiotherapy was greater than that of PR group.Conclusion: ?DCE-MRI can make the boundary of the tumor more clearly;?DWI unites DCE-MRI,the sensibility of tumor radiotherapy can be judged according to the rise of later ADC value and the decline of MRE value as well as the rangeability,and moreover,the radiotherapeutic effect can be evaluated and monitored in the treatment process,which has a high clinical value for the curative effect evaluation of cervical cancer before and after radiotherapy.