DWI在肝癌非手术治疗中疗效评价的应用进展

发布时间：2019-07-19 07:09

【摘要】：晚期肝癌不能行手术切除时,可采取其它非手术治疗方法,术前预测,治疗前后预测及早期准确判断其疗效是非切除治疗最大获益的关键,直接决定患者的后续治疗方案及预后。现已有不同的疗效评估方法,基本是形态学的评估,可靠性及准确性不够且没有标准化。而目前认为反映组织微观变化的MR扩散加权成像(DWI)技术,可以先于肿瘤形态学的变化反映肿瘤活性,可进行肿瘤治疗前疗效预测及治疗后早期的评估。体素内不相干运动(IVIM)是一种最新的DWI技术,可在ADC值基础上分离出反映组织单纯扩散状态的参数D,组织灌注相关的扩散参数D*和组织灌注参数f,为肿瘤的治疗评估提供更多的量化信息,有望提高对HCC非手术治疗评价的可靠性和准确性。本文就上述内容的研究进展进行综述,旨在进一步深化临床研究对肝癌非手术治疗的疗效评价,推动DWI技术在临床实践中广泛开展。
[Abstract]:When advanced liver cancer can not be resected, other non-surgical treatment methods can be adopted. preoperative prediction, prediction before and after treatment and early accurate judgment of its curative effect are the key to the greatest benefit of non-resection treatment, which directly determines the follow-up treatment plan and prognosis of the patients. At present, there are different evaluation methods of curative effect, which are basically morphological evaluation, and the reliability and accuracy are not enough and there is no standardization. At present, it is considered that the MR diffusion-weighted imaging (DWI) technique, which reflects the microscopic changes of the tissue, can reflect the tumor activity ahead of the morphological changes of the tumor, and can predict the curative effect of the tumor before treatment and evaluate it in the early stage after treatment. Incoherent motion (IVIM) in voxel is a new DWI technique. On the basis of ADC value, the parameter D, the diffusion parameter D * and tissue perfusion parameter f related to tissue perfusion can be separated on the basis of ADC value, which provides more quantitative information for tumor treatment evaluation and is expected to improve the reliability and accuracy of non-surgical treatment evaluation of HCC. In this paper, the research progress of the above contents is reviewed in order to further deepen the evaluation of the curative effect of clinical research on the non-surgical treatment of liver cancer and promote the extensive development of DWI technology in clinical practice.
【作者单位】：复旦大学附属中山医院放射科;上海市影像医学研究所;复旦大学上海医学院影像学系;
【分类号】：R735.7;R445.2

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