3.0T MR动态增强扫描定量参数评估肝动脉化疗栓塞术治疗进展期肝细胞癌疗效的价值  

Application value of quantitative parameters of 3.0T MR dynamic contrast enhancement scan in the evaluation of efficacy of transcatheter arterial chemoembolization on advanced hepatocelluar caricinoma

作　　者：马彦高[1] 曾宪强[1] 王宝锋[1] 曹伟光[1] 翟涛[1] 胡欣 Ma Yangao;Zeng Xianqiang;Wang Baofeng;Cao Weiguang;Zhai Tao;Hu Xin(Department of Radiology,Nanyang Central Hospital,Nanyang 473000,China)

机构地区：[1]河南省南阳市中心医院放射科,473000

出　　处：《中国实用医刊》2019年第24期61-64,共4页Chinese Journal of Practical Medicine

摘　　要：目的 研究3.0T MR动态增强扫描(DCE-MRI)定量参数在评估肝动脉化疗栓塞(TACE)治疗进展期肝细胞癌(HCC)疗效中的应用价值。方法 抽取2013年6月至2017年6月南阳市中心医院拟行TACE治疗的124例进展期HCC患者进行前瞻性研究,分别于治疗前后对患者进行T1WI、T2WI和DCE-MRI扫描,选择感兴趣区域并建立药代动力学双室模型,计算定量参数容量运转常数(Ktrans)、速率常数(Kep)和血管外/细胞外间隙容积(Ve),根据治疗效果将入选患者分为两组并比较Ktrans、Kep和Ve差异,作受试者工作特征曲线(ROC)分析各参数对TACE治疗效果评估价值。结果 TACE术后1个月评估结果显示124例进展期HCC患者中治疗有效者92例(74.19%),术前1周时有效组Ktrans高于无效组(P<0.05),两组Kep和Ve比较差异有统计学意义(P<0.05),术后1个月时有效组Ktrans和Kep降低(P<0.05),无效组Kep降低(P<0.05),且有效组Ktrans和Kep低于无效组,差异有统计学意义(P<0.05);Ktrans和Kep用于评估TACE疗效的灵敏度分别为0.826和0.674,特异度分别为0.875和0.781,差异有统计学意义(P<0.05),Ktrans和Kep联合评估的灵敏度和特异度分别为0.935和0.875,其临床价值明显升高(P<0.05)。结论 DCE-MRI定量参数Ktrans和Kep用于评估TACE对进展期HCC治疗效果具有较高临床价值,较传统影像学检查和半定量分析更为客观准确。Objective To study the application value of quantitative parameters of 3.0T MR dynamic contrastenhancement scan(DCE-MRI)in the evaluation of efficacy after transcatheter arterial chemoembolization(TACE)on advanced hepatocelluar caricinoma(HCC).Methods A total of 124 patients with advanced HCC who were scheduled to undergo TACE in Nanyang Central Hospital from June 2013 to June 2017 were selected for prospective studies.T1WI,T2WI and DCE-MRI scans were performed before and after treatment,and the regions of interest were selected and pharmacokinetic dual-chamber model was established.The quantitative parameters of volume transfer constant(Ktrans),rate constant(Kep)and extravascular/extracellular space volume(Ve)were calculated.The selected patients were divided into two groups according to the treatment effects.And the differences in Ktrans,Kep and Ve were compared.And the receiver operating characteristic curve(ROC)was used to analyze thevalue of each parameter in evaluating the treatment effects of TACE.Results Evaluated results at 1 month after TACE showed there were 92 cases(74.19%)of effective treatment among 124 patients with HCC.The Ktrans in effective group was significantly higher than that in ineffective group at 1 week before operation(P<0.05),and there were significant differences in the Kep and Ve between the two groups(P<0.05).The Ktrans and Kep were significantly decreased in effective group at 1 month after operation(P<0.05),and the Kep was significantly decreased in ineffective group(P<0.05),and the Ktrans and Kep in effective group were lower than those in ineffective group(P<0.05).The sensitivities of Ktrans and Kep in evaluating TACE efficacy were 0.826 and 0.674 respectively,and the specificities were 0.875 and 0.781 respectively(P<0.05),and the sensitivity and specificity of Ktrans combined with Kep were 0.935 and 0.875 respectively,and their clinical value was significantly increased(P<0.05).Conclusions DCE-MRI quantitative parameters Ktrans and Kep have high clinical value in evaluating the

关 键 词：肝癌 肝动脉化疗栓塞 磁共振动态增强扫描 定量参数 疗效评估 

分 类 号：R735[医药卫生—肿瘤] R44[医药卫生—临床医学]