全肝MR灌注成像评价肝细胞癌经导管动脉化疗栓塞短期效果的价值  

MR perfusion imaging of the liver： early findings after transcatheter arterial chemoembolization of hepatocellular carcinoma

作　　者：卞读军[1] 肖恩华[1] 肖运平[1] 陈翔宇[1] 司徒卫军[1] 贺忠[1] 袁术文[1] 孙剑宁[1] 

机构地区：[1]中南大学湘雅二医院放射科,长沙410011

出　　处：《中华放射学杂志》2010年第12期1248-1252,共5页Chinese Journal of Radiology

基　　金：＂十一五＂国家科技支撑计划重点项目（2007BAI05B06）;国家自然科学基金资助项目（30070235、30470508、30870695）;湖南省自然科学基金重点项目（06JJ20081）

摘　　要：目的 观察肝细胞癌患者经导管动脉化疗栓塞（TAGE）治疗前后MR PWI表现和灌注值的改变.方法 回顾性分析经穿刺活检病理证实的肝细胞癌患者28例,在TACE术前和术后3～10 d分别进行MR PWI,得出术前及术后负增强积分（NEI）、病灶达峰值时间（TTP）、最大信号下降斜率（MSD）和信号增强比（SER）,采用t检验比较TACE术前与术后上述各指标的差异.结果 肝细胞癌瘤区时间信号曲线（TIC）TACE术前呈快速下降,TACE术后趋向平缓;TTP及SER术前分别为（51.2±10.3）s和60.6±36.3,术后分别为（43.7±12.0）s和41.2±27.5,术后较术前降低;NEI值术后为149.6±80.1,术前为108.7±58.9,术后较术前升高,差异均有统计学意义（P＜0.05）.MSD值术后较术前降低,但差异无统计学意义（P＞0.05）.结论 MR PWI能够敏感地观察到TACE术前后的血流变化,用于评价TACE早期疗效.Objective To investigate the value of MR perfusion imaging in early detection of findings following arterial chemoembolization of hepatocellular carcinoma Methods Twenty eight consecutive patients with pathologically-confirmed HCC were evaluated. All patients underwent MR perfusion imaging at pre-TACE and 3 to 10 days after TACE. The negative enhancement integral （NEI） ,the time to peak（TTP） ,the maximum slope of decrease （MSD） , the signal enhance ratio （SER） were acquired from MRI software FuncTool 2. 5.36a Version. Statistical analysis using SPSS 14, least significant difference test （t test） were utilized. Results The time intensive curve of tumor was observed to descend rapidly to reach the peak at pre-TACE studies, whereas it descended slowly to reach the peak on post TACE studies. The Value of TTP and SER prior to TACE were（51.2 ± 10. 3） s, 60. 6 ± 36. 3 respectively, and post TACE （43.7 ± 12. 0）s, 41.2 ±27. 5 respectively. The values of TTP and SER post TACE were lower than those prior to TACE （P ＜ 0. 05）. The value of NEI prior to TACE was 108.7 ± 58.9, and after TACE 149. 6 ±80. 1 and there was statistically significant difference （P ＜0. 05）. The Value of MSD post TACE were lower than those prior to TACE, but there was no statistical significance （P ＞ 0. 05）. Conclusion PWI is a very sensitive imaging technique that can be used to monitor early dynamic changes of HCC following TACE.

关 键 词：肝肿瘤 磁共振成像 放射学 介入性 

分 类 号：R686[医药卫生—骨科学]