Hricak H, Swift P S, Campos Z, Quivey J M, Gildengorin V, Göranson H
Department of Radiology, University of California, San Francisco 94143-0628.
Radiology. 1993 Nov;189(2):381-8. doi: 10.1148/radiology.189.2.8210364.
To analyze the value of magnetic resonance (MR) imaging after radiation therapy for cancer of the cervix.
Eighty-nine MR images were retrospectively studied in 69 patients aged 46.3 years +/- 11.5. MR findings of tumor recurrence and irradiation changes were correlated with time after radiation therapy; paracentral radiation dose (dose to point A); and in patients with pretreatment images, primary tumor size and stage.
Overall accuracy of MR in diagnosis of tumor recurrence was 78% (positive predictive value, 65%; negative predictive value, 97%). In MR examinations less than 6 months after the beginning of radiation therapy, accuracy (69%) and specificity (46%) were significantly lower than in examinations more than 6 months later (88%, P = .0032; 81%, P = .0166, respectively). Comparison of pre- and posttreatment MR findings and knowledge of stage or initial tumor size did not affect MR results.
Overall, diagnosis was best with unenhanced T2-weighted images, but in patients with adnexal or pelvic sidewall recurrence and in patients with treatment complications (eg, fistula formation), contrast enhancement did help.
分析宫颈癌放疗后磁共振成像（MR）的价值。
回顾性研究了69例年龄为46.3岁±11.5岁患者的89幅MR图像。将肿瘤复发和放疗改变的MR表现与放疗后的时间、中央旁放疗剂量（A点剂量）相关联；对于有治疗前图像的患者，还与原发肿瘤大小和分期相关联。
MR诊断肿瘤复发的总体准确率为78%（阳性预测值为65%；阴性预测值为97%）。在放疗开始后不到6个月的MR检查中，准确率（69%）和特异性（46%）显著低于6个月后的检查（分别为88%，P = 0.0032；81%，P = 0.0166）。治疗前后MR表现的比较以及分期或初始肿瘤大小的信息并不影响MR结果。
总体而言，未增强的T2加权图像诊断效果最佳，但对于附件或盆腔侧壁复发的患者以及有治疗并发症（如瘘管形成）的患者，对比增强确实有帮助。
