肝脏扩散加权MRI在检测消融后肿瘤存活中的应用  

Application of Diffusion Weighted MR in Detecting Viable Hepatic Tumor in Ablative Therapy

作　　者：郑晓林[1] 徐辉雄[1] 吕明德[1] 谢晓燕[1] 徐作峰[1] 赖英荣[2] 

机构地区：[1]广州中山大学附属第一医院医学影像部 [2]广州中山大学附属第一医院医学病理科,510080

出　　处：《临床放射学杂志》2006年第2期153-157,共5页Journal of Clinical Radiology

摘　　要：目的探讨扩散加权(DWI)MRI在判断肝脏肿瘤经皮热消融后局部疗效中的价值。资料与方法对48例接受了经皮射频或微波消融治疗的肝脏肿瘤患者进行DWI和常规MRI检查,观察两者的表现,测量消融灶各组织成分的表观扩散系数(ADC)值,对DWI和常规MRI显示存活肿瘤的能力进行半定量分析、比较,计算DWI检出存活肿瘤的敏感性和特异性。结果常规MRI不能准确区分消融灶内的组织成分。DWI能区分消融灶内的组织成分,各组织成分的ADC值(单位为mm2/s×10-3)不同,即消融坏死0·44±0·21、肝充血1·96±0·14、肉芽组织2·28±0·24、存活肿瘤1·24±0·08、肝脏1·69±0·08,各成分间差异均有统计学意义(P<0·05)。DWI对存活肿瘤的检出次数、显示清晰程度均高于常规MRI(P<0·05),检出存活肿瘤的敏感性为88%,特异性为90%。结论DWI对肝脏消融治疗后存活肿瘤的检出能力高于常规MRI,具有一定的应用价值。Objective To evaluate the value of diffusion weighted imaging in detecting viable tumor after ablative therapy of hepatic tumor. Materials and Methods DWI and conventional MRI were performed in 48 patients with hepatic tumor after ablative therapy. The hepatic MRI manifests of ablative therapy were observed. The ADC values of various tissue components were measured. The capability of that DWI and conventional MR revealed viable tumor were semiquantitatively analyzed and compared. The sensitivity and specificity of DWI to detect viable tumor were respectively calculated. Results Conventional MRI could not differentiate various tissue components of ablative foci. The ADC values of various components in ablative foci （unit： mm^2/s × 10^-3 ） were different such as ablative necrosis was 0.44 ± 0.21, hepatic congestion 1.96 ± 0.14, granulation tissue 2.28 ± 0.24, viable tumor 1.24 ± 0.08 and normal llve 1.69 ± 0.08. The data were significant difference（ P 〈 0.05）. The times to detect viable tumor and the definition to display tumor of DWI were superior to that of conventional MRI. The sensitivity and specificity for DWI to detect viable tumor were 88% and 90% respectively. Conclusion DWI provides the better capability to detect viable tumor of ablative therapy than with conventional MRI, and it is deserved to be applied.

关 键 词：扩散加权成像 肝脏肿瘤 消融治疗 肿瘤存活 半定量分析 

分 类 号：R730.5[医药卫生—肿瘤] R730.4[医药卫生—临床医学]