磁共振弥散加权成像对晚期肝细胞肝癌患者分子靶向药物治疗的疗效评估  

The utility of DWI in the efficacy evaluation of advanced hepatocellular carcinoma treated by molecule targeted drug therapy

作　　者：谌力群[1] 陈武标[2] 朱辉严[1] 刘华强[3] 李勇[3] 

机构地区：[1]广东省农垦中心医院(湛江肿瘤医院)放射科,广东湛江524002 [2]广东医学院附属医院放射科,广东湛江524002 [3]广东省农垦中心医院(湛江肿瘤医院)肿瘤科,广东湛江524002

出　　处：《临床和实验医学杂志》2016年第14期1433-1437,共5页Journal of Clinical and Experimental Medicine

摘　　要：目的探讨磁共振弥散加权成像(DWI)评估晚期肝细胞肝癌患者分子靶向药物治疗疗效的价值。方法选择2013年1月至2014年12月间收治行分子靶向药物治疗的晚期肝细胞癌患者12例。依据患者治疗效果分为治疗有反应组(5例)和无反应组(7例)。对两组治疗前后病灶最大径和肿瘤表观弥散系数(ADC值)进行观察,并进行统计学分析。结果 MR检查:治疗后,有反应患者病灶的T1WI和T2WI信号增大,DWI信号无明显变化;无反应患者病灶的T1WI、T2WI、DWI信号均无明显变化。病灶最大径:治疗前后,与无反应组比较,有反应组患者的最大径明显偏大(P<0.05)。ADC值:b=500 s/mm^2时,治疗前,有反应组患者病灶ADC值显著高于无反应组(P<0.05),b=800 s/mm^2时则无明显差异(P>0.05);有反应组治疗前后ADC值出现明显变化,而无反应组治疗前后ADC值变化不明显(P>0.05)。治疗前,有反应组患者病灶最大径和ADC值(b=500 s/mm^2)呈正相关性(R=0.556,P=0.038);无反应组患者病灶最大径和ADC值无明显相关性。结论 DWI可以为晚期HCC分子靶向药物治疗的预后评估提供独特的功能信息,是潜在的及时、准确评估患者预后的工具。Objective To investigate the value of DWI in advanced hepatocellular liver cancer treated by molecule targeted drug thera- py. Methods Twelve cases of patients with advanced hepatocellular carcinoma treated by molecular targeted drug therapy from January 2013 to December 2014 were selected. Based on the treatment results, patients were divided into responders group （5 cases） and non - responders （7 cases）. Before and after treatment, the lesion maximum diameter and tumor apparent diffusion coefficient （ ADC value） of two groups were ob- sewed and statistically analyzed. Results MR examination： after treatment, the T1 WI and T2WI signal were increased and DWI signal had no significantly change in responders group; the T1 WI, T2WI, and DWI signal had no significantly change in non - responders group. The maxi- mum lesion diameter： before and after treatment, compared with non - respondet＇s, maximum diameter of responders group was significantly lar- ger （ P 〈 0.05 ）. ADC value ： b = 500 s/mm^2 , before treatment, ADC values of responders group was significantly higher than non - respond- ers group （ P 〈 0.05 ）, but there was no significant difference at b = 800 s/mm^2 （ P 〉 0.05 ）. There was no significantly changes of ADC val- ues between before and after treatment in non - responders group （ P 〉 0.05 ）. Before treatment, the relationship between lesions maximum diameter and ADC values （ b = 500 s/mm^2 ） in responders group was positively correlated （ 11 = 0. 556, P = 0. 038 ）, but was no significant correlated lesions in non - responders group. Conclusion DWI can provide unique information features for advanced HCC treated by molecular targeted drug therapy and would be a timely and accurate potential assessment tool for prognosis.

关 键 词：肝细胞肝癌 靶向 磁共振弥散加权 

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