动态弥散加权成像对HCC的TACE术疗效评价的临床应用  

The clinical application of dynamic diffusion-weighted imaging in evaluating the treatment of HCC after TACE

作　　者：侯红军[1] 许祖闪[1] 万绪明[1] 

机构地区：[1]山东省威海市文登中心医院影像科,山东威海264400

出　　处：《医学影像学杂志》2014年第3期395-398,共4页Journal of Medical Imaging

摘　　要：目的 探讨动态弥散加权成像对HCC的TACE术疗效评价的临床应用价值.方法 对确诊为HCC的46例患者在TACE治疗前1～3天、6h、24h、1个月、3个月采用平扫T1WI、FST2 WI、DWI扫描,术前诊断及术后1～3个月复查均行FST1WI动态增强扫描,DWI序列中弥散梯度因子（b值）分别取600、800、1 000s/mm2,测量ADC值,并与血管造影对比.结果 肿瘤的ADC值在TACE术后较术前升高,术前与术后1个月平均ADC值比较,差异有统计学意义.疗效良好的癌灶术后6h ADC值明显减低,术后24h至术后1、3个月,ADC值呈上升趋势;疗效中等的癌灶术后6h ADC值不均匀减低,术后24h始至术后1、3个月ADC值呈不均匀上升趋势;疗效差的癌灶术后6h ADC值无明显变化,术后24h始至术后1、3个月ADC值呈不均匀轻度降低.结论 动态DWI对HCC的TACE术疗效评估有重要的临床应用价值.Objective To explore the clinical value of transcatheter arterial chemoembolization in treatment of primary hepatocellular carcinoma with dynamic diffusion-weighted imaging.Methods Forty-six patients diagnosed with HCC who underwent TACE were assessed.The MRI was carried out at 1～3 days pre TACE and at 6 hours,24 hours,1 month and 3 months post-TACE respectively and the sequence included unenhanced and contrast-enhanced T1-weighted imaging,FS F2-weighted imaging and diffusion-weighted imaging,for the DWI,the diffusion gradient factor （b value） were taken 600,800,1000 s/mm2 respectively,the corresponded ADC values were measured and compared with angiography.Results The mean ADC values of HCCs after TACE increased than preoperation,there was statistically significance between the difference of mean ADC values of pre and one month post TACE.For those with good response to TACE,the ADC value significantly reduced in six hours after surgery then displayed a tendency of rising in 24 hours and 1～3 months after surgery; for those with moderate response to TACE,the ADC value reduced inconsistently in six hours and displayed non-uniformly ascension in 24 hours and 1～3 months after surgery,while for those poor response to TACE,the ADC value had no significant changes in six hours and decreased slightly and inhomogeneously in 24 hours and 1～3 months after surgery.Conclusion The dynamic diffusion-weighted imaging has an important clinical role for evaluating the treatment of HCC af ter TACE.

关 键 词：弥散加权成像 ADC值 肝动脉灌注化疗栓塞术 磁共振成像 

分 类 号：R445.2[医药卫生—影像医学与核医学] R735.7[医药卫生—诊断学]