磁共振扩散加权成像早期评估热消融肝癌疗效的价值  

The application of MR diffusion-weighted image in the evaluation of early therapeutic effect of local thermal ablation for hepatocellular carcinoma

作　　者：潘晶晶[1] 于杰[2] 钟燕[2] 唐业欢[2] 叶慧义[2] 

机构地区：[1]第二炮兵总医院医学影像科,北京100088 [2]解放军总医院,北京100853

出　　处：《中国临床医学影像杂志》2013年第10期706-708,711,共4页Journal of China Clinic Medical Imaging

摘　　要：目的:探讨磁共振扩散加权成像(DWI)早期评估热消融肝癌疗效的价值。方法:21个肝细胞癌于热消融前、消融完成后24 h内行不同b值下的DWI检查。比较相同b值下病灶消融前后ADC值的差异。用受试者工作特征(ROC)曲线分析活性肿瘤与坏死组织的ADC值。结果:相同b值下肿瘤消融后的ADC值均较消融前升高,差异均具有统计学意义(P<0.01)。ROC曲线显示b值为800、1 000 s/mm2时,ADC值鉴别二者有意义。b值为1 000 s/mm2时,ADC值阈值为1.09×10-3mm2/s时诊断肿瘤坏死的灵敏度为89.5%,特异度为63.2%;选择阈值为1.26×10-3mm2/s时诊断肿瘤坏死的灵敏度为52.6%,特异度为89.5%。结论:DWI在早期评价热消融肝癌疗效中有一定价值。Objective： To investigate the application of MR diffusion-weighted image （DWI） in evaluating the early thera- peutic effect of local thermal ablation for hepatocellular carcinoma （HCC）. Methods： Twenty-one nodules histologically proved HCC in 21 patients were enrolled. All patients received DWI with different b values before and immediately after （within 24 hours） local thermal ablation. The differences of ADC values with the same b values between pre- and post-ablation were measured. Receiver operating characteristic （ROC） curve analysis was performed for the comparison of viable tumor and necros- tic tissue. Results： The ADC value post-ablation increased significantly than pre-ablation of each b value （P〈0.01）. The ADC value was an effective parameter for identifying necrotic tissue： when b value was 1 000 s/mm^2, a threshold value of 1.09×10^-3mm^2/s permitted 89.5% sensitivity and 63.2% specificity and a threshold value of 1.26×10^-3mm^2/s permitted 52.6% sensitiv-ity and 89.5% specificity. Conclusion： DWI has the capacity of evaluating early therapeutic effect of thermal ablation for HCC.

关 键 词：肝肿瘤 磁共振成像 弥散 

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