Sugimura K, Furukawa T, Okizuka H, Yuasa K, Mihara Y, Ishida T
Department of Radiology, Shimane Medical University.
Nihon Gan Chiryo Gakkai Shi. 1990 Nov 20;25(11):2693-701.
MRI findings of pelvic radiation changes in 42 patients were correlated with the tumor and critical tissue dose, time post treatment, and clinical symptoms. The severity of tissue changes was graded. The ability of MRI to differentiate post radiation tissue changes from residual or recurrent tumor was also correlated. Radiation tissue toxicity increased significantly when the dose exceeded 4,500 cGy, with the incidence of marked rectal changes rising from 8% to 44% with a dose greater than 4,500 cGy. All grades of tissue change were seen in the rectum of time from start of therapy. All patients who exhibited clinical grade 2 or 3 rectal changes showed moderate or severe changes on MRI. Grade 1 MRI changes indicative of mucosal edema were present in 33% of patients with no clinical symptoms. In conclusion, the gradation and sequence of MRI changes following radiation therapy to the pelvis have been documented and correlated with clinical findings. With its potential for distinguishing radiation change from recurrent tumor. MRI should prove to be of value in the assessment of the post-radiation pelvis.
对42例盆腔放疗后改变的患者进行MRI检查，将其结果与肿瘤及关键组织剂量、治疗后时间和临床症状进行关联分析。对组织改变的严重程度进行分级。还对MRI区分放疗后组织改变与残留或复发性肿瘤的能力进行了关联分析。当剂量超过4500 cGy时，放射性组织毒性显著增加，剂量大于4500 cGy时，明显直肠改变的发生率从8%升至44%。从治疗开始后的不同时间，在直肠中均可见到各级组织改变。所有出现临床2级或3级直肠改变的患者在MRI上均显示中度或重度改变。33%无临床症状的患者MRI显示1级改变，提示黏膜水肿。总之，已记录盆腔放疗后MRI改变的分级和序列，并与临床结果相关联。由于MRI有区分放射性改变与复发性肿瘤的潜力，在评估放疗后的盆腔时应具有重要价值。
