MR扩散成像在肝细胞癌经导管动脉化疗栓塞术后疗效评价中的价值  

The clinical value of MR diffusion-weighted imaging in hepatocellular carcinoma after transcatheter arterial chemoembolization

作　　者：肖运平[1,2] 肖恩华[2] 罗建光[2] 卞读军[2] 贺忠[2] 尚全良[2] 梁斌[2] 李默秋[3] 

机构地区：[1]广西医科大学第五附属医院,柳州市人民医院放射科,广西柳州545001 [2]中南大学湘雅二医院放射科,湖南长沙410011 [3]中南大学湘雅二医院病理科,湖南长沙410011

出　　处：《中国医学影像技术》2008年第2期270-273,共4页Chinese Journal of Medical Imaging Technology

基　　金：国家自然科学基金(30070235、30470508);湖南省自然科学基金(06JJ20081);湖南省科技厅基金(04-SK-306-2)资助

摘　　要：目的通过病理、影像对照研究,探讨磁共振扩散成像(DWI)在肝细胞癌经导管动脉化疗栓塞术后疗效中的临床价值。方法15例经导管动脉化疗栓塞(TACE)后行Ⅱ期切除的肝细胞癌患者,术前24～48h进行磁共振扩散成像,肿瘤切除后对标本进行病理观察,并与术前DWI进行对照分析。结果①病理与DWI对照:肿瘤存活区多为高信号(12/15),亦可为等信号(3/15);凝固性坏死区多为低信号(8/15),亦可为等信号(6/15),1例呈高信号(1/15)。肿瘤成活区与坏死区ADC值分别为(1.42±0.16)×10-3mm2/s、(1.58±0.18)×10-3mm2/s,两者之间差异有统计学意义(t=2.618,P<0.05)。②不同坏死程度的整个肿瘤ADC值差异有统计学意义(χ2=7.236,P<0.05)。结论肝癌TACE后DWI表现具有一定的特征性,DWI能较好地鉴别肿瘤成活、坏死组织,并反映肿瘤坏死情况,有助于TACE疗效的评价。Objective To assess the clicical value of diffusion-weighted imaging （DWI） in hepatocellular carcinoma （HCC） after transcatheter arterial chemoembolization （TACE） through comparison with its pathology. Methods DWIs were performed in 15 patients with HCC which were treated by TACE within 24-48 hours before Ⅱ-phase operation. The DWI findings were analyzed in liver lesions and correlated with pathological findings. Results ①DWI fingdings and its pathology： the signal intensity of viable tumors were mostly hyper-signal （12/15） and seldom iso-signal （3/15）, whereas concretionary necrosis lesions were hypo-signal （8/15） or iso-signal （6/15）, hyper-signal（1/15）. The ADC values of zones of viable tumor and necrosis in tumor were （1.42±0.16）×10-3 mm2/s, （1.58±0.18）×10-3 mm2/s respectively. Significant difference of ADC values was seen between the two zones （t=2.618, P〈0.05）. ②There was significant difference in ADC values of the whole tumor among tumors with different necrotic degrees （χ2=7.236, P〈0.05）. Conclusion The DWI features of HCC after TACE are of certain characteristic, DWI can identify viable and necrotic tumor tissue and reflect necrotic degree of tumor in HCC after TACE, which is helpful for us to evaluate curative effect of TACE.

关 键 词：肝肿瘤 栓塞 治疗性 磁共振成像 

分 类 号：R735.7[医药卫生—肿瘤] R445.2[医药卫生—临床医学]