MRI功能成像对肝动脉化疗栓塞治疗肝细胞肝癌的疗效评价

发布时间：2018-08-13 16:56

【摘要】：目的探讨磁共振功能成像指标评价肝动脉化疗栓塞(TACE)治疗肝细胞肝癌疗效的可行性。方法搜集行肝动脉化疗栓塞术治疗的30例原发性肝细胞肝癌患者,对治疗前后磁共振功能成像参数进行比较分析。结果治疗后磁共振波谱(MRS)参数胆碱/脂质(Cho/Lip)峰下面积比值较术前降低,治疗前后比较有显著性差异(P0.05)。治疗后动态增强MRI(DCE-MRI)灌注定量指标容积转移常数(K~(trans))、组织间隙-血浆速率常数(k_(ep))、肝动脉灌注指数(HPI)较术前降低,而表观扩散系数(ADC)值较术前增高,治疗前后比较差异有统计学意义(P0.05)。K~(trans)降低率与肿瘤坏死率呈正相关(r=0.751,P0.01)。术前和术后肿瘤ADC值和Cho/Lip比值均呈负相关,r值分别为-0.386、-0.407(P0.05)结论磁共振功能成像指标ADC值、k_(ep)值、HPI、Cho/Lip峰下面积比值对于评价TACE治疗肝癌疗效有一定价值,Ktrans值有较高价值,在肿瘤治疗疗效预测中有较大意义。
[Abstract]:Objective to evaluate the feasibility of hepatic artery chemoembolization (TACE) in the treatment of hepatocellular carcinoma (HCC). Methods 30 patients with primary hepatocellular carcinoma treated by transcatheter arterial chemoembolization (TACE) were collected and compared with the parameters of Mr functional imaging before and after treatment. Results after treatment, the ratio of choline / lipid (Cho/Lip) subpeak area of (MRS) was significantly lower than that before and after treatment (P0.05). After treatment, the dynamic enhanced MRI (DCE-MRI) perfusion quantitative index volume transfer constant (K ~ (trans),) interstitial plasma rate constant (K _ (ep),) hepatic artery perfusion index (HPI) was decreased, while the apparent diffusion coefficient (ADC) was increased. The difference before and after treatment was statistically significant (P0.05). The decrease rate of K- (trans) was positively correlated with the rate of tumor necrosis (r = 0.751a, P0.01). There was a negative correlation between preoperative and postoperative tumor ADC value and Cho/Lip ratio (P 0.05). Conclusion the ADC value and (ep) value of Mr functional imaging index and the ratio of area under HPICho-Lip peak are valuable in evaluating the curative effect of TACE in the treatment of hepatocellular carcinoma. It has great significance in predicting the curative effect of tumor therapy.
【作者单位】：浙江大学医学院附属第二医院放射科;浙江省绍兴市人民医院放射科;
【基金】：浙江省中医药科技研究基金项目(编号:2012ZB157) 绍兴市公益性应用计划项目(编号:2013D10039) 浙江省医药卫生一般研究计划项目(编号:201465315)
【分类号】：R445.2;R735.7

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