Monzen Y, Mori H, Matsumoto A, Yoshida S, Wakisaka M, Komatsu E, Tashiro M, Hori Y
Department of Radiology, Hiroshima Prefectural Hiroshima Hospital.
Nihon Igaku Hoshasen Gakkai Zasshi. 1995 Sep;55(11):745-50.
To evaluate the usefulness of magnetic resonance imaging (MRI) in diagnosing residual or recurrent tumors of cervical cancer after radiation therapy, we investigated the time difference between MRI and gynecologic findings in the diagnosis of residual or recurrent tumor in 12 patients with invasive cervical cancer. We defined a positive finding for residual or recurrent tumor as an uterine cervical mass isointense to muscle on T1-weighted images and hyperintense on T2-weighted images, and when a positive biopsy specimen was obtained. Two patients were diagnosed as having a residual or recurrent tumor by MRI. Positivity was demonstrated four and seven months later, respectively. MRI was more useful in the earlier diagnosis of residual or recurrent tumor of cervical cancer after radiation therapy than uterine biopsy. There was one patient whose differentiation from residual tumor or radiation-induced necrosis or inflammation on MRI was difficult. MRI and gynecologic check-up at a regular interval after radiation therapy was needed to distinguish them. One patient was diagnosed as having a recurrent tumor by gynecologic finding three month earlier than by MRI. Follow-up MRI examinations at a regular interval in addition to gynecologic examination is necessary for the early detection of recurrent cervical cancer after radiation therapy.
为评估磁共振成像（MRI）在诊断宫颈癌放疗后残留或复发肿瘤中的作用，我们调查了12例浸润性宫颈癌患者在诊断残留或复发肿瘤时MRI与妇科检查结果的时间差异。我们将残留或复发肿瘤的阳性发现定义为子宫颈肿块在T1加权图像上与肌肉等信号、在T2加权图像上呈高信号，且获取到阳性活检标本时。2例患者经MRI诊断为有残留或复发肿瘤。阳性结果分别在4个月和7个月后得到证实。MRI在宫颈癌放疗后残留或复发肿瘤的早期诊断中比子宫活检更有用。有1例患者在MRI上难以区分残留肿瘤与放射性坏死或炎症。放疗后需要定期进行MRI和妇科检查以鉴别它们。1例患者经妇科检查诊断为复发肿瘤比经MRI诊断早3个月。除妇科检查外，定期进行MRI随访检查对于放疗后早期发现复发性宫颈癌是必要的。
