Blomlie V, Rofstad E K, Tropé C, Lien H H
Department of Radiology, Norwegian Radium Hospital, Montebello, Oslo.
Radiology. 1997 May;203(2):391-7. doi: 10.1148/radiology.203.2.9114093.
To evaluate the findings in the irradiated critical soft-tissue organs of the female pelvis at magnetic resonance (MR) imaging within 30 months after radiation therapy.
Twenty-three patients (13 premenopausal and 10 postmenopausal women) with advanced cervical carcinoma underwent 276 MR examinations (T1- and T2-weighted imaging) scheduled before, three times during, and 7 weeks and 3, 6, 9, 12, 18, 24, and 30 months after the end of radiation therapy. A visual evaluation of the ureters, bladder, rectum, parametrium, and perivesical and perirectal soft tissues was performed by two radiologists.
Fifteen abnormally wide ureters (diameter range, 7-23 mm; mean diameter, 14 mm) were seen in 10 (seven premenopausal and three postmenopausal women) (43%) of 23 patients at a median time of 18 months after the end of radiation therapy (range, 9-30 months). An abnormally wide ureter was a transient finding in eight (53%) of 15 abnormal ureters. Two premenopausal women (9%) of 23 patients had rectovaginal fistulas. One of these two patients also had a vesicovaginal fistula.
Ureteral dilatation was seen in nearly half of the patients and occurred more frequently in premenopausal women than in postmenopausal women. Knowledge about the appearances of radiation-induced abnormalities of the critical soft tissues may be of help in the interpretation of MR images of the pelvis.
评估放射治疗后30个月内女性盆腔受照射关键软组织器官在磁共振（MR）成像上的表现。
23例晚期宫颈癌患者（13例绝经前女性和10例绝经后女性）在放射治疗结束前、治疗期间3次以及治疗结束后7周、3、6、9、12、18、24和30个月接受了276次MR检查（T1加权和T2加权成像）。两名放射科医生对输尿管、膀胱、直肠、宫旁组织以及膀胱周围和直肠周围软组织进行了视觉评估。
23例患者中有10例（7例绝经前女性和3例绝经后女性，占43%）在放射治疗结束后中位时间18个月（范围9 - 30个月）时发现15条输尿管异常增宽（直径范围7 - 23 mm；平均直径14 mm）。15条异常输尿管中有8条（53%）的输尿管增宽为一过性表现。23例患者中有2例绝经前女性（9%）发生直肠阴道瘘。这2例患者中的1例还伴有膀胱阴道瘘。
近半数患者出现输尿管扩张，且绝经前女性比绝经后女性更常见。了解放射诱导的关键软组织异常表现可能有助于解释盆腔的MR图像。
