结合MR增强扫描测量肿瘤表观扩散系数值对大肝癌TACE的疗效评价  

Evaluation of the Therapeutic Effect of Transcatheter Arterial Chemoembolization in Massive Hepatocellular Carcinoma Using ADC Value Measurements Combined with Contrast-enhanced MR Imaging

作　　者：王化[1] 邹强[2] 刘佩芳[1] 叶兆祥[1] 

机构地区：[1]天津医科大学附属肿瘤医院放射科,天津市肿瘤防治重点实验室,天津市300060 [2]天津医科大学附属肿瘤医院介入治疗科

出　　处：《中国肿瘤临床》2012年第16期1204-1207,共4页Chinese Journal of Clinical Oncology

摘　　要：目的:结合MR增强扫描,探讨表观扩散系数(ADC)值测量在大肝癌经导管动脉化疗栓塞(TACE)疗效评价中的作用。方法:收集TACE治疗前及TACE后4～6周接受常规MRI、扩散加权成像(b=500,0 s/mm^2)及动态增强成像检查的大肝癌患者32例,比较TACE前后各病灶ADC值,并比较TACE治疗后肿瘤强化区和无强化区及与TACE前ADC值的差异。结果:TACE后整个病灶的ADC值[(1.39±0.18)×10^(-3)mm^2/s]较TACE前[(1.23±0.19)×10^(-3)mm^2/s升高(P=0.016)。TACE后肿瘤无强化区的ADC值(1.80±0.32)×10^(-3)mm^2/s]明显高于肿瘤强化区的ADC值(1.15±0.30)×10^(-3)nm^2/s](P<0.001),肿瘤强化区的ADC值明显低于TACE前的ADC值(P=0.048),肿瘤无强化区的ADC值明显高于TACE前的ADC值(P<0.001)。结论:ADC值有助于判断肿瘤活性,分别测量肿瘤强化区和无强化区的ADC值能更准确地评估大肝癌对TACE的治疗反应。Objectives： The therapeutic effect of transcatheter arterial chemoembolization （ TACE ） in massive hepatocellular carcinoma （ HCC ） using apparent diffusion coefficient （ ADC ） value measurements combined with gadolinium-enhanced magnetic resonance imaging （ MRI ） was evaluated. Methods： Routine, diffusion-weighted （ b = 500, 0 s/mm2 ）, and dynamic contrast-enhanced MRI were performed before and 4 wk to 6 wk after TACE in 32 patients with massive HCC. The ADC values in the whole tumor were measured and compared pre- and post-treatment The ADC values in the enhanced and unenhanced tumor portions were also measured after treatment. The obtained values as well as the ADC values before treatment in the enhanced and unenhanced portions were also compared. Results： The tumor ADC values significantly increased from （ 1.23 ± 0.19 ） × 10^3 mm2/s before TACE to （ 1.39± 0.18 ） x 103 mm2/s after TACE （ P = 0.016 ）. The ADC values in the unenhanced tumor portion [（ 1.80 ±0.32 ） × 10^3 mm2/s ] were significantly greater than those in enhanced portion [（ 1.15 ± 0.30 ） × 10^3 mm2/s ] after TACE （ P 〈 0.001 ）. The ADC values in the enhanced tumor portion were significantly lower than those before TACE （ P = 0.048 ）. The ADC values in the unenhanced tumor portion were significantly higher than those before TACE （ P 〈 0.001 ）. Conclusion： The ADC value may be beneficial in assessing tumor viability. Measuring the ADC value of the enhanced and unenhanced portions of a tumor may be more accurate in evaluating the therapeutic response of massive HCC to 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]