动态对比增强MRI对结肠癌肝转移瘤TACE治疗前后微循环灌注改变及近期疗效评价

发布时间：2018-03-17 12:23

本文选题：结肠癌肝转移瘤　切入点：经导管动脉化疗栓塞术　出处：《介入放射学杂志》2016年06期 　论文类型：期刊论文

【摘要】：目的探讨结肠癌肝转移瘤经导管动脉化疗栓塞(TACE)治疗前后动态对比增强磁共振成像(DCE-MRI)各定量参数的变化及其对预后评估的价值。方法对21例经病理证实为低分化腺癌的结肠癌肝转移患者分别于TACE术前及术后进行常规MRI和DCE-MRI扫描。以两腔室模型为基础,计算出定量血流动力学参数(K~(trans)、K_(ep)、V_e)。比较TACE术前、术后各参数的变化;分别探讨患者近期疗效与TACE术后DCE-MRI各项参数的相关性;并比较不同预后患者TACE术后各参数的差别。结果 TACE术后肿瘤组织的K~(trans)、K_(ep)及V_e值呈下降趋势,且术前术后差别有统计学意义。DCE-MRI各项参数与CEA、CA125、CA199和CA242值无明显相关性。术后近期疗效评估示完全缓解3例(14.3%),部分缓解11例(52.4%),总有效率(RR)66.7%,疾病控制率(DCR)90.5%。其中RR、PCR均与术后K~(trans)值呈正相关(r=0.526,P=0.005;r=0.557,P=0.006),但与K_(ep)、V_e值无明显相关性。结论结肠癌肝转移瘤TACE治疗前后DCE-MRI各定量血流动力学参数变化显著,术后肿瘤组织中的K~(trans)值可作为结肠癌肝转移TACE治疗早期疗效评估指标,为结肠癌肝转移瘤个体化治疗和治疗方案的修正提供依据,其远期疗效与DCE-MRI定量参数的相关性需进一步深入研究。
[Abstract]:Objective to investigate the changes of quantitative parameters of DCE-MRI before and after transcatheter arterial chemoembolization (TACEE) of hepatic metastases of colon cancer and their prognostic value. Methods 21 cases with pathologically proved low differentiation were studied. Conventional MRI and DCE-MRI scans were performed before and after TACE in patients with liver metastasis of colon cancer from adenocarcinoma. To calculate the quantitative hemodynamic parameters and to compare the changes of the parameters before and after TACE, and to explore the correlation between the short-term curative effect and the parameters of DCE-MRI after TACE. Results the tumor tissue of TACE patients showed a decreasing trend of KT / KAP and V\ + +\\\%. There was no significant correlation between the parameters of DCE-MRI and the values of CA125CA199 and CA242 before and after operation. The short-term curative effect evaluation showed complete remission in 3 cases and partial relief in 11 cases. The total effective rate was 66.7%, and the disease control rate was 90.5%. There was a positive correlation between the value of KG translocation and the value of TACE. Conclusion the changes of hemodynamic parameters of DCE-MRI were significant before and after TACE treatment, but there was no significant correlation between the value of KG and the value of Ve in patients with hepatic metastasis of colon cancer before and after TACE treatment, but there was no significant correlation between the value of KG and the value of Ve in patients with colon cancer liver metastases before and after TACE treatment. The value of KT in tumor tissue after operation can be used as an index to evaluate the early curative effect of TACE in the treatment of liver metastasis of colon cancer, and to provide basis for individualized treatment and revision of treatment scheme for liver metastases of colon cancer. The relationship between the long-term effect and the quantitative parameters of DCE-MRI needs further study.
【作者单位】：南京军区南京总医院医学影像科;
【基金】：国家自然科学基金(81471632)
【分类号】：R735.35;R445.2

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