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目的分析宫颈癌放疗中与放疗后盆部骨髓MR改变。探讨MR成像对显示盆部骨髓损伤的临床价值。方法48例经病理证实的宫颈癌患者在放射治疗前及治疗中和治疗后不同时间段行盆腔的轴位SET1WI,轴位及矢状位TSET2WI,冠状位SPIR,以及Gd-DTPA增强后T1WISE的轴位、冠状位、矢状位扫描。在MR图像上观察盆部骨髓在放疗前后的信号改变。结果骨髓信号最早出现改变是在外照射开始后第8天,患者受照剂量在12Gy时。放疗早期,骨髓在T1WI,T2WI及SPIR序列上信号升高,T1WI增强扫描见强化。放疗晚期,骨髓的T1WI,T2WI信号升高程度增加,SPIR序列出现信号降低,T1WI增强扫描,骨髓强化不明显。53%的患者在T1WI、T2WI上,18%的患者在SPIR序列上见照射野外骨髓信号有改变。结论宫颈癌外照射放疗可引起照射野内、外骨髓多种MR信号改变,并有一定规律性,对宫颈癌临床治疗有指导意义。
Objective To analyze the changes of MR in pelvic bone after radiotherapy and radiotherapy of cervical cancer. To investigate the clinical value of MR imaging in the display of pelvic bone marrow injury. Methods 48 cases of pathologically confirmed cervical cancer patients before and after treatment and treatment of pelvic axial position SET1WI, axial and sagittal TSET2WI, coronal SPIR, and Gd-DTPA enhanced T1WISE Axial, coronal, sagittal scan. Observed in the MR image pelvic bone marrow signal changes before and after radiotherapy. Results The earliest change of bone marrow signal was on the 8th day after the start of external irradiation, when the dose was 12Gy. In the early stage of radiotherapy, the signal of the bone marrow is increased on the T1WI, T2WI and SPIR sequences, and enhanced on the T1WI enhanced scan. Late radiotherapy, bone marrow T1WI, T2WI increased signal intensity, SPIR sequence signal decreased, T1WI enhanced scan, bone marrow enhancement was not obvious. Fifty-three percent of patients had T1WI, T2WI, and 18% of patients had seen changes in the wild-bone marrow signal on the SPIR sequence. Conclusion External beam radiotherapy of cervical cancer can cause many kinds of MR signals in the field and outside bone marrow to change, with certain regularity. It is instructive for the clinical treatment of cervical cancer.