体素内不相干运动扩散加权成像对肝癌经导管肝动脉化疗栓塞治疗短期疗效预测及评估价值  

The predictive value of IVIM-DWI on short-term therapeutic effect and prognosis of TACE on hepatocellular carcinoma

作　　者：马霄虹[1] 王爽[1] 赵心明[1] 王倩[1] 朱永健[1] 欧阳汉[1] 周纯武[1] 

机构地区：[1]国家癌症中心/中国医学科学院北京协和医学院肿瘤医院影像诊断科,北京100021

出　　处：《磁共振成像》2017年第4期248-253,共6页Chinese Journal of Magnetic Resonance Imaging

基　　金：公益性行业科研专项基金资助(编号:201402019);中国癌症基金会北京马拉松专项基金资助(编号:LC2016B15)~~

摘　　要：目的探讨体素内不相干运动扩散加权成像(intravoxel incoherent motion diffusion-weighted imaging,IVIM-DWI)定量指标在肝细胞性肝癌(hepatocellular carcinoma,HCC)经导管肝动脉化疗栓塞(transcatheter arterial chemoembolization,TACE)治疗的短期疗效预测及评估价值。材料与方法 90例HCC患者1次TACE治疗前后均行IVIM-DWI检查,测得肿瘤最大层面的IVIMDWI定量指标:慢速扩散系数(slow apparent diffusion coefficient,D)、快速扩散系数(fast apparent diffusion coefficient,D*)、快速扩散系数所占比例(fraction of fast apparent diffusion coefficient,f)值。根据实体肿瘤疗效评估标准(modified response evaluation criteria in solid tumors,m RECIST)进行随诊,将病例分为稳定组和进展组。组内用配对t检验、组间用独立t检验进行比较。结果 (1)TACE治疗前,稳定组与进展组的D、D*值差异有统计学意义(P<0.05);(2)1次TACE治疗后,两组之间的ΔD、ΔD*值差异有统计学意义(P<0.05);(3)1次TACE治疗前后的D及D*值差异有统计学意义(P<0.05)。结论 IVIM-DWI定量指标(D和D*值及其变化值)对肝癌TACE短期疗效预测和评估具有一定价值。Objective： To investigate the prognosis value of intravoxel incoherent postoperative early response and short-term motion diffusion-weighted imaging （IV1M- DWI） quantitative parameters for the patients with hepatocellular carcinoma （HCC） treated by transcatheter arterial chemoembolization （TACE）. Materials and Methods： Ninety patients with biopsy-proven or clinical diagnostic HCC underwent IVIM-DWI on a 3.0 T MR scanner before TACE, and 90 HCC patients took the same MR scan one month after TACE. The quantitative parameters were measured on the maximal tumor region, including D, D＊ and f value before and after TACE. The patients were divided into progress group and stable group based on mRECIST as criterion. All data were statistically analyzed. Results： There were significant differences between progress group and the stable group in D and D＊ values of the tumor before TACE （P〈 0.05, respectively）. One month after TACE, the AD and AD＊ values of the tumor had significant differences between the two groups （P〈0.05, respectively）. The D and D＊ values of tumors had significant differences before and after TACE （P〈0.05, respectively）. Conclusion： The D, D＊ values of the IV1M-DWI could predict the efficacy before TACE in HCC patients. Furthermore, the IVIM-DWI as a noninvasive method might evaluate the early response after TACE in HCC patients.

关 键 词：肝肿瘤 磁共振成像 扩散加权成像 体素内不相干运动 肝动脉 栓塞 治疗性 

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]