肝癌伽玛刀治疗后磁共振表现  

MRI Appearances of Liver Carcinoma after Gamma Knife Therapy

作　　者：朱海云[1] 张福琛[1] 叶菁[1] 张永秋[1] 柏挺[1] 

机构地区：[1]解放军第85医院放射科,上海200052

出　　处：《实用放射学杂志》2008年第12期1627-1629,共3页Journal of Practical Radiology

摘　　要：目的评价MRI平扫和动态增强对肝癌伽玛刀治疗后表现和疗效随访的价值。方法回顾性分析57例肝癌伽玛刀治疗后MRI表现,并与AFP结果进行对照。结果肝癌伽玛刀治疗后平扫主要有4种表现:(1)T1WI稍低信号,T2WI稍高信号。(2)T1WI和T2WI均呈稍低信号。(3)T1WI稍高信号,T2WI等稍高混杂信号。(4)T1WI和T2WI均呈稍高信号。坏死病灶动态增强扫描表现为:(1)持续环形强化;(2)蜂窝状强化;(3)病灶本身无强化,周围肝组织斑片状强化。复发癌灶或新发癌灶在动态增强时早期强化,延迟期造影剂退出。小肝癌组(<5 cm)肿瘤完全坏死率93.5%,大肝癌组肿瘤(≥5 cm)完全坏死率81.8%。2组疗效比较差异无统计学意义(P=0.244)。结论MRI平扫和动态增强评价伽玛刀的疗效可靠、准确,伽玛刀术后定期MRI随访具有重要意义。Objective To study the value of unenhanced and dynamic contrast - enhanced MR imaging in follow - up of liver carcinomas after gamma knife therapy. Methods 57 patients examined by MR imaging after gamma knife therapy were analyzed retrospectively, and compared with outcome of AFP. Results Lesions treated with gamma knife therapy on precontrast imaging showed 4 kinds of appearances： （1） Slightly low signal intensity on T1WI and slightly high signal intensity on T2WI. （2） Slightly low signal intensity on both T1WI and T2WI. （3 ）Slightly high signal intensity on T1WI,isointensity and slightly high signal heterogeneous intensity on T2WI. （4） Slightly high signal intensity on both T1 WI and T2WI. The necrotic lesions showed sustained ring -shaped or honeycomb enhancement or patching enhancement in hepatic tissue around the lesions with lesions unenhancing. Recurrent lesions or new lesions were enhanced in arterial phase, followed by rapid wash - out in the delay phase. The rate of completely necrosis was 93.5 % in small liver carcinoma group（ 〈 5 cm ） ,81.8% in large liver carcinoma group （ ≥ 5 cm ）. The curative effect in two groups had no statistic significant （ P = 0. 244 ）. Conclusion Using unenhanced and dynamic MR imaging to evaluate the curative effect of gamma knife therapy is reliable and accurate. Hepatic carcinomas followed - up regularly by MR imaging after gamma knife therapy has important significance.

关 键 词：肝脏 肝癌 伽玛刀 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]