Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
Department of Radiology, The Christie NHS Foundation, 550 Wilmslow Rd, Manchester, M20 4BX, UK.
Abdom Radiol (NY). 2017 Oct;42(10):2488-2512. doi: 10.1007/s00261-017-1179-3.
Historically, cancer treatment has emphasized measures for the "cure" regardless of the long-term consequences. Advances in cancer detection and treatment have resulted in improved outcomes bringing to the fore various quality of life considerations including future fertility. For many young cancer patients, fertility preservation is now an integral component of clinical decision-making and treatment design. Optimal fertility-sparing options for young patients with gynecologic cancer are influenced by patient age, primary cancer, treatment regimens, and patient preferences. Possible approaches include embryo or oocyte cryopreservation, ovarian transposition, conservative surgery, and conservative medical treatment to delay radical surgery. These may be used alone or in combination to maximize fertility preservation. Awareness of the various fertility-sparing options, eligibility criteria, and the central role of magnetic resonance imaging in the proper selection of patients will enable radiologists to produce complete clinically relevant imaging reports and serve as effective consultants to referring clinicians. Knowledge of the potential imaging pitfalls is essential to avoid misinterpretation and guide appropriate management.
从历史上看，癌症治疗一直强调“治愈”措施，而不顾及长期后果。癌症检测和治疗的进步带来了更好的治疗效果，凸显了各种生活质量方面的考虑因素，包括未来的生育能力。对于许多年轻的癌症患者来说，生育力保存现在是临床决策和治疗设计的一个组成部分。影响妇科癌症年轻患者最佳生育力保存选择的因素包括患者年龄、原发癌症、治疗方案和患者偏好。可能的方法包括胚胎或卵母细胞冷冻保存、卵巢移位、保留手术和保守治疗以延迟根治性手术。这些方法可以单独使用或联合使用，以最大限度地保留生育能力。了解各种生育力保存选择、资格标准以及磁共振成像在正确选择患者中的核心作用，将使放射科医生能够生成完整的具有临床相关性的成像报告，并作为有效的顾问为转介临床医生提供服务。了解潜在的成像陷阱对于避免误解和指导适当的管理至关重要。
