MR表观扩散系数值评价肝细胞癌载药微球经导管肝动脉化疗栓塞术后早期疗效  

Study on the apparent diffusion coefficient of MR in evaluating the early treatment response of hepatocellular carcinoma after drug-eluting bead transcatheter arterial chemoembolization

作　　者：罗天扬 雒利军 刘涛 LUO Tianyang;LUO Lijun;LIU Tao(Imaging Center,Baiyin First People's Hospital,Baiyin,Gansu Province 730900,China)

机构地区：[1]白银市第一人民医院影像中心,甘肃白银730900

出　　处：《实用放射学杂志》2022年第8期1297-1301,共5页Journal of Practical Radiology

摘　　要：目的探讨MR表观扩散系数(ADC)值评价肝细胞癌(HCC)载药微球经导管肝动脉化疗栓塞(DEB-TACE)术后早期疗效的价值.方法纳入经DEB-TACE治疗的HCC患者,依据修订版实体瘤疗效评价标准(mRECIST)分为有效组和无效组.运用t检验及受试者工作特征(ROC)曲线分析术前ADC(ADC_(pre))、术后1月ADC(ADC_(1month))、ADC变化值(ADC_(change))、ADC变化率(ADC_(ratio))诊断DEB-TACE术后早期疗效的价值.结果共纳入79例HCC患者的86个病灶,有效组ADC_(1month)、ADC_(change)、ADC_(ratio)值较无效组高(P<0.05),但ADC_(pre)值无明显差异(P>0.05).ADC_(ratio)、ADC_(change)、ADC_(1month)值诊断DEB-TACE术后有效组、无效组的曲线下面积(AUC)值分别为0.87[95%置信区间(CI)0.79~0.94]、0.83(95%CI 0.73~0.90)、0.75(95%CI 0.65~0.84),组间两两比较差异均显著(P<0.05).结论MR ADC值能反映DEB-TACE术后早期治疗效果,ADC_(ratio)值对DEB-TACE术后疗效评价具有较高诊断价值.ObjectiveTo investigate the value of MR apparent dffusion coefficient(ADC)in evaluating the early treatment response in hepatocellular carcinoma(HCC)patients after drug-eluting bead transcatheter arterial chemoembolization(DEB-TACE).Methods HCC patients treated with DEB-TACE were included and divided into effective and noneffective groups according to modified Response Evaluation criteria in Solid Tumors(mRECIST).Then,t-test and receiver operating characteristic(ROC)curve were performed to compare the values of ADC_(pre),ADC_(1mocth),ADC_(change) and ADC_(ratio) in evaluating the early treatment response after DEB-TACE.Results A total of 86 lesions from 79 HCC patients were included.The values of ADC_(1month),ADC_(change) and ADC_(ratio) of the effective group were higher than those of the noneffective group(P<0.05),while ADC_(pre) demonstrated nonsignificant differences(P>0.05).The area under the curve(AUC)values of ADC_(ratio),ADC_(change) and ADC_(1month) in diagnosing the effective group and noneffective group were O.87[95% confidence interval(CI)0.790.94],0.83(95%CI 0.73-0.90)and 0.75(95%CI 0.65-0.84),respectively,and pairwise comparisons were statistically significant among the three parameters(P<0.05).Conclusion The ADC of MR can reflect the DEB-TACE treatment effect,the ADC_(ratio) value demonstrated higher diagnostic value after DEB-TACE.

关 键 词：磁共振成像 表观扩散系数 肝细胞癌 载药微球经导管肝动脉化疗栓塞 

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] R815[医药卫生—临床医学]