MRI扫描评估原发性肝癌患者TACE术后病灶残留价值研究*

doi:10.3969/j.issn.1672-5069.2025.03.029

摘要/Abstract

摘要： 目的探讨磁共振成像(MRI)检查评估经导管动脉栓塞化疗(TACE)术后原发性肝癌(PLC)患者病灶残留的价值。方法 2020年6月～2022年8月我院收治的116例PLC患者,均接受TACE治疗。术后3个月以数字减影血管造影(DSA)检查为评估的金标准,分析CT和MRI检查评估TACE术后肿瘤残存的效能。结果在116例PLC患者146个病灶中,术后3月经DSA检查显示有肿瘤残存103个病灶,另43个病灶稳定;MRI检查判断肿瘤残余的灵敏度、准确度和阴性预测值分别为92.2%、94.5%和84.3%,均显著高于CT检查(分别为73.8%、81.5%和61.4%,P＜0.05);在TACE术后103个残存病灶中,DSA检查显示碘油沉积Ⅰ型10个、Ⅱ型51个、Ⅲ型35个和Ⅳ型7个;MRI检查对Ⅰ型和Ⅱ型碘油沉积类型检出率分别为70.0%和90.2%,均显著高于CT检查(分别为10.0%和64.7%, P＜0.05);在TACE术后,MRI检查判断肿瘤有包膜54个(37.0%),而CT检查仅发现肿瘤有包膜16个(11.0%,P＜0.05),差异显著。结论 MRI检查评估TACE术后PLC患者肝内病灶残留效能高,对进一步治疗有很大的指导意义。

关键词: 原发性肝癌, 经导管动脉栓塞化疗, 病灶残留, 磁共振成像, 诊断

Abstract: Objective The aim of this study was to investigate evaluation of intrahepatic residual lesions by magnetic resonance imaging (MRI) scan in patients with primary liver cancer (PLC) after transcatheter arterial chemoembolization (TACE). Methods 116 patients with PLC were encountered in our hospital between June 2020 and August 2022, and all underwent TACE therapy for one to three times at interval of one month. Patients were followed-up and had digital subtraction angiography (DSA), MRI and CT scan by end of three months. Diagnostic performance of MRI and CT scan was evaluated based on DSA golden criteria. Results Of 146 lesions in 116 patients with PLC, there were 103 residual tumor lesions and 43 lesions at complete remission states showed by DSA by end of three months after TACE; sensitivity, accuracy and negative predictive value by MRI scan in determining residual tumors were 92.2%, 94.5% and 84.3%, all significantly higher than 73.8%, 81.5% and 61.4% (P＜0.05) by CT scan; of 103 residual tumors after TACE, DSA found iodine oil deposition type Ⅰ in 10 cases, type Ⅱ in 51 cases, type Ⅲ in 35 cases and type Ⅳ in 7 cases; the positive rates of type Ⅰ and Ⅱ showed by MRI scan were 70.0% and 90.2%, both much higher than 10.0% and 64.7%, respectively (P＜0.05) by CT scan; after TACE therapy, MRI scan showed enveloped tumors in 54 cases (37.0%), much higher than 16 cases (11.0%) by CT scan (P＜0.05). Conclusion MRI scan has a satisfactory diagnostic efficacy in assessing residual tumor lesions after TACE therapy, which might play a pivotal role in making strategy for further treatment in this setting.

Key words: Hepatoma, Transcatheter arterial chemoembolization, Residual tumors, Magnetic resonance imaging, Diagnosis

董彦宏, 姜琨, 黄辉, 彭钊, 程艾. MRI扫描评估原发性肝癌患者TACE术后病灶残留价值研究^*[J]. 实用肝脏病杂志, 2025, 28(3): 434-437.

Dong Yanhong, Jiang Kun, Huang Hui, et al. MRI evaluation of intrahepatic residual lesions in patients with primary liver cancer after transcatheter arterial chemoembolization[J]. Journal of Practical Hepatology, 2025, 28(3): 434-437.

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MRI扫描评估原发性肝癌患者TACE术后病灶残留价值研究^*

MRI evaluation of intrahepatic residual lesions in patients with primary liver cancer after transcatheter arterial chemoembolization

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