摘要
目的:通过影像-病理对照,评价磁共振成像(MRI)判断原发性肝癌(HCC)碘油栓塞(TACE)治疗后肿瘤坏死和残存的准确性。方法:23例TACE后行Ⅱ期手术切除的HCC患者,手术前1周内行MRI检查,包括SE序列和FMP- SPGR多回合动态增强扫描。手术后沿MRI扫描平面作5-10mm层厚肿瘤连续切面和HE染色病理大切片。结果:23例患者MRI共显示31个病灶,采用动态增强和T2W1相结合,MRI准确判断28个病灶的肿瘤坏死和残存,准确率为90．3％。2个纤维间隔包裹和1个包膜下少量肿瘤残存未能显示。结论:动态增强和T2W1相结合,MRI能准确评价碘油栓塞后肿瘤坏死和残存,但对于纤维间隔包裹或增强早期无强化的包膜下少量肿瘤残存的判断仍有局限性。
Objective：To evaluate the accuracy of magnetic resonance imaging （MRI） in demonstrating the tumor necrosis and viability of hepatocellular carcinoma （HCC） after transcatheter arterial chemoembolization （TACE） with lipiodol. Methods： 23 patients treated by TACE underwent MRI examination within 1 week before Ⅱ-staged resection. MRI was performed with SE sequence and FMPSPGR sequence dynamic multi-phase contrast scans. All specimens were cut into 5-10mm thickness, corresponding to the same plane as that of the MRI scans. The specimens were embedded in paraffin using routine hematoxylin and eosin staining with serial section of gross pathologic specimen excised. MRI findings were thus compared with those of pathology. Results：A total of 31 lesions were identified in 23 patients on MRI images. Areas of necrosis and residual viable tumor of 28 lesions were demonstrated accurately by combining with dynamic-contrast scans and SE T2WI, and the accuracy was 90.3% MRI failed to show small residual tumor encapsulated by fibrosis septa in 2 lesions and beneath the capsule in one lesion. Conclusion： Combined with dynamic multi-phase contrast scans and SE T2WI, MRI can evaluate accurately the areas of necrosis and residual viable tumor of HCCs after TACE with lipiodol, but has limitation in assessing small residual viable tumor encapsulated by fibrosis septa or subcapsular that was no enhancement on early-phase enhanced scanning.
出处
《中国临床医学》
北大核心
2006年第4期663-665,共3页
Chinese Journal of Clinical Medicine
基金
2004年卫生部部属(管)医疗机构临床学科重点项目
上海市医学重点学科项目
关键词
肝细胞癌
化疗栓塞
磁共振成像
疗效
Hepatocellular carcinoma
Chemoembolization
Magnetic resonance imaging
Therapeutic effect
