TACE术后肝细胞癌患者功能磁共振成像参数变化研究

doi:10.3969/j.issn.1672-5069.2020.05.030

摘要/Abstract

摘要： 目的探讨肝动脉化疗栓塞(TACE)治疗的肝细胞癌(HCC)患者磁共振(MR)弥散加权成像(DWI)和动态增强扫描参数的变化。方法 2014年6月～2019年6月我院收治的HCC患者76例,均接受TACE治疗。治疗前后进行MR检查,记录表观扩散系数(ADC)、容积转移常数(K_trans)和组织间隙-血浆速率常数(K_ep)。结果在TACE治疗前,76例HCC患者病灶ADC为(1.1±0.1)×10^-3mm²/s, K_trans为(1.4±0.3)min^-1,K_ep为(1.9±1.1)min^-1,与治疗后(分别为(1.4±0.2)×10^-3mm²/s, K_trans为(0.7±0.2)min^-1,K_ep为(1.3±1.0)min^-1)比,差异显著(P<0.05),而治疗前后病灶大小并无显著变化【(7.7±3.2)cm对(6.5±2.8) cm】;在76例经TACE治疗的HCC患者中,应答59例(77.6%); 59例应答患者治疗后病灶ADC为(1.4±0.4)×10^-3mm²/s,显著大于17例未应答患者【(1.1±0.3)×10^-3mm²/s,P<0.05】,K_trans为(0.8±0.2)min^-1,显著低于未应答患者【(1.2±0.4)min^-1,P<0.05】,而两组病灶大小【(6.6±3.1)cm对(7.4±3.8)cm】、治疗前ADC【(1.1±0.2)×10^-3mm²/s对(1.0±0.2)×10^-3mm²/s】和K_ep值【(1.4±0.3)min^-1对(1.4±0.4)min^-1】比较,无显著性差异(P>0.05)。结论 TACE治疗的HCC患者肿瘤病灶功能磁共振成像参数可能会发生一些特征性变化,了解这些变化对判断疗效可能具有指导意义,值得进一步研究。

关键词: 肝细胞癌, 肝动脉化疗栓塞, 功能磁共振成像, 弥散加权成像, 表观扩散系数, 治疗 , ,

Abstract: Objective The purpose of this study was to evaluate the changes of magnetic resonance (MR) diffusion-weighted imaging (DWI) and dynamic contrast-enhanced scanning parameters in patients with hepatocellular carcinoma (HCC) after transcatheter arterial chemoembolization (TACE) therapy. Methods A total of 76 patients with HCC were treated with TACE in our hospital from June 2014 through June 2019, and all received MR before and after TACE for apparent diffusion coefficient (ADC) , the volume transfer constant (K_trans) and the tissue space-plasma rate constant (K_ep). Results Before the TACE treatment in the 76 patients with HCC, the ADC of tumor foci was (1.1±0.1)×10^-3mm²/s, K^t_ranswas (1.4±0.3)min^-1, K_ep was (1.9±1.1)min^-1, significantly different as compared to after TACE, while there was no significant difference between the tumor sizes 【(7.7±3.2)cm vs.(6.5±2.8) cm】 before and after TACE; 59 patients (77.6%) got response to TACE out of the 76 patients with HCC, and in the 59 responders, the ADC was (1.4±0.4)×10^-3mm²/s, much greater than【(1.1±0.3)×10^-3mm²/s, P<0.05】 in 17 non-responders, and the K_trans was (0.8±0.2)min^-1, significantly lower than 【(1.2±0.4)min^-1, P<0.05】 in non-responders, while there were no significant differences with respect to the tumor sizes 【(6.6±3.1)cm vs.(7.4±3.8)cm】, the ADC before TACE 【(1.1±0.2)×10^-3mm²/s vs. (1.0±0.2)×10^-3mm²/s】 and the K_ep 【(1.4±0.3)min^-1 vs. (1.4±0.4)min^-1】 between the two groups (P>0.05). Conclusions The ADC and K_Tran_s of functional magnetic resonance imaging of tumor foci in patients with HCC after TACE might change specifically, which could help clinicians evaluate the therapeutic efficacy.

Key words: Hepatoma, Transcatheter arterial chemoembolization, Functional magnetic resonance imaging, Diffusion-weighted imaging, Apparent diffusion coefficient, Therapy

周彬彬, 孙姚晨, 黄海帆, 鲍健. TACE术后肝细胞癌患者功能磁共振成像参数变化研究[J]. 实用肝脏病杂志, 2020, 23(5): 723-726.

Zhou Binbin,Sun Yaochen,Huang Haifan, et al.. Evaluation of functional magnetic resonance imaging in patients with hepatocellular carcinoma after TACE[J]. Journal of Practical Hepatology, 2020, 23(5): 723-726.

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