磁共振弥散加权成像对肝癌肝移植术后肿瘤复发的监测  

Monitoring of the recurrent hepatic lesions after liver transplantation with hepatic malignant tumors by diffusion-weighted MR imaging

作　　者：钟群[1] 陈自谦[1] 陈锦华[2] 聂玫[1] 陈代文[1] 叶友强[1] 涂正刚[1] 陈振[1] 郭林红[1] 

机构地区：[1]南京军区福州总医院医学影像中心,福州350025 [2]南京军区福州总医院经管科,福州350025

出　　处：《中华器官移植杂志》2009年第4期228-230,共3页Chinese Journal of Organ Transplantation

基　　金：福建省青年科技人才创新项目（2006F3105）

摘　　要：目的探讨磁共振弥散加权成像（DWI）对肝癌肝移植术后肿瘤复发的监测及其应用价值。方法对14例肝癌肝移植受者术后进行了监测，采用磁共振（MRI）扫描仪进行常规增强平扫，其中横断位T2加权序列应用FRFSE序列、脂肪抑制T2加权序列应用Is—FRFSE序列、DWI应用SE-EPI序列，对各扫描序列的图像信号进行了分析，判断有无肝癌复发，并分别记录和比较各扫描序列检出的肝癌病灶数，计算和比较各扫描序列间的噪声比（CNR）及肿瘤与肝脏实质间的表观弥散系数（ADC）。结果FRFSE、Is-FRIRFSE及SE-EPI序列对肿瘤的信号强度依次由弱到强，其确认检出病灶数分别为25、27和27个，CNR分别为（25．856±10．122）、（37．988±17．403）和（69．535±32．730），三组间CNR的比较，差异均有统计学意义（P〈0．05）。肿瘤和肝脏实质ADC分别为（0．00163±0．00078）mm^2／s和（0．00140±0．00029）mm^2／s，两者比较，差异有统计学意义（P〈0．05），ADC伪彩图中，肿瘤组织信号等于或低于肝脏实质，但色彩不均一。结论DWI对肝癌肝移植术后肿瘤复发的慵测敏感有效，有良好的廊用价值。Objective To evaluate the application of diffusion-weighted magnetic resonance imaging （DWI） in monitoring the recurrent lesions after liver transplantation with hepatic malignant tumors. Methods FRFSE sequence, fs-FRFSE sequence and DWI with single-shot echo-planar imaging were performed on 14 patients after allo-transplantation of the liver with hepatic malignant tumors. The signals of lesions were delineated in 3 sequences after scanning. And the detection rate of lesions was compared with the other two sequences. Mean values for contrast-to-noise ratio （CNR） with DWI were compared with those for T2 weighted images. And mean values for apparent diffusion coefficient （ADC） between tumor and hepatic parenchyma were compared. Results The signal of recurrent lesions was low to high with FRFSE, fs-FRIRFSE and SE-EPI sequence. Significant difference was found in detection rate of lesions among these 3 sequences （25, 27, 27 respectively）. The mean values for CNRs were 25. 856 ± 10. 122 for FRFSE sequence, 37. 988 ± 17. 403 for fsFRFSE sequence, and 69. 535 ± 32. 730 for DWI respectively; and CNR of DWI was significantly higher than that of FRFSE and fs-FRFSE （P〈0. 05）. The mean values for ADCs of hepatic malignant tumors （0.00140 ± 0.00029 mma/s） were significantly lower than that of hepatic parenchyma （0. 00163 ± 0. 00078 mm^2/s） （P〈0. 05）. The uneven signal of tumor was equal to or lower than that of hepatic parenchyma in ADC maps. Conclusion DWI may be useful for monitoring of recurrent masses after liver transplantation with hepatic malignant tumors for its acute sensitivity and effectiveness.

关 键 词：磁共振弥散成像 肝移植 肝肿瘤 复发 

分 类 号：R686[医药卫生—骨科学]