摘要
目的:探讨弥散加权成像(DWI)联合动态对比增强磁共振成像(DCE-MRI)在肝细胞癌患者肝动脉化疗栓塞术(TACE)后肿瘤活性检测中的应用价值。方法:选取行TACE术的肝细胞癌患者65例为研究对象,于术前行MRI检查并经病理学证实。依据TACE术后6~8周数字减影血管造影术(DSA)检查结果评价肿瘤活性,分为肿瘤活性区、邻近正常肝实质区及肿瘤坏死区。比较不同区域DCE-MRI定量参数容量转移常数(K^(trans))、速率常数(K_(ep))、血管外细胞外间隙容积比(V_(e)值)及DWI参数ADC值,分析上述参数对三个区域的鉴别效能。结果:65例患者共获得肿瘤活性区、邻近正常肝实质区及肿瘤坏死区分别为70个、70个和59个。上述区域K^(trans)、K_(ep)、ADC两两比较差异有统计学意义(均P<0.05)。ROC分析显示,以K^(trans)、K_(ep)、ADC值截断值为临界值,可较好地鉴别肿瘤活性区与邻近正常肝实质区,以及肿瘤活性区与肿瘤坏死区,且以联合检测的鉴别价值最佳(均P<0.05)。结论:DWI联合DCE-MRI技术检测可以较好地评估肝细胞癌患者TACE术后肿瘤活性,有利于早期发现残余活性肿瘤及复发病灶。
Objective:To investigate the application value of diffusion-weighted imaging(DWI)combined with dynamic contrast enhanced magnetic resonance imaging(DCE-MRI)in the detection of tumor activity in patients with hepatocellular carcinoma after transcatheter arterial chemoembolization(TACE).Methods:A total of 65 HCC patients who underwent TACE were enrolled in this study.MRI was performed before TACE and confirmed by pathology.According to the results of DSA at 6 to 8 weeks after TACE,the tumor activity was evaluated and divided into tumor activity area,adjacent normal liver parenchyma area and tumor necrosis area.The quantitative parameters of DCE-MRI,including K^(trans),K_(ep),V_(e) and ADC value,were compared among the three regions,and the differential efficacy of the above parameters in the three regions was analyzed.Results:A total of 70 active tumor areas,70 adjacent normal liver parenchyma areas and 59 tumor necrosis areas were obtained in 65 patients,respectively.There were significant differences in K^(trans),K_(ep)and ADC between any two areas(all P<0.05).ROC analysis showed that the cut-off values of K^(trans),K_(ep)and ADC values could be used as the critical values to distinguish the active tumor area from the adjacent normal liver parenchyma area,as well as the active tumor area from the necrotic tumor area,and the combined detection had the best differential value(all P<0.05).Conclusion:DWI combined with DCE-MRI can better evaluate the tumor activity of hepatocellular carcinoma patients after TACE,which is conducive to the early detection of residual tumor and recurrent lesions.
作者
张振奇
贺莉
ZHANG Zhenqi;HE Li(Department of Imaging,Bozhou Hospital of Traditional Chinese Medicine,Bozhou 236800,China)
出处
《陕西医学杂志》
CAS
2024年第6期773-776,781,共5页
Shaanxi Medical Journal
基金
安徽省中医药传承创新科研项目(2022CCZC11)。
关键词
肝细胞癌
弥散加权成像
动态对比磁共振成像
容量转移常数
速率常数
鉴别价值
Hepatocellular carcinoma
Diffusion weighted imaging
Dynamic contrast enhanced MRI
Capacity transfer constant
Rate constant
Differential value
