【摘要】 目的探讨弥散加权成像(DWI)及其MRI增强扫描在TACE介入术后早期疗效中的评估价值。方法以2015年6月-2016年8月我院收治的210例肝癌TACE介入治疗患者为对象,纳入患者术前和术后分别行DWI扫描检查及MRI增强扫描检查,参照实体瘤疗效评估标准(RECIST)将治疗结果分为有效组及无效组,观察患者治疗前后影像学表现,并比较两组治疗前、后影像学定量变化。结果 210例患者,共检出260个肝癌病灶,肿瘤平均直径约为7.56cm,肝癌患者TACE治疗前后影像学表现具有典型性;术后肝癌患者病灶ADC值较术前明显升高,肝癌患者术后CER动脉期、SIR动脉期值较术前明显减小,差异有统计学意义(P<0.05);术后与无效组相比较,有效组肝癌病灶的ADC值明显大,但CER动脉期、SIR动脉期值明显小,差异有统计学意义(P<0.05)。结论 DWI及其MRI增强扫描可有效评估肝癌TACE介入术后病灶存活及坏死情况,对评估早期临床疗效及指导临床下一步治疗方案有重要参考价值。更多还原

【Abstract】 Objective To investigate the value of diffusion weighted imaging(DWI) and its MRI enhanced scan in evaluating the early curative effect of transcatheter arterial chemoembolization(TACE) interventional therapy on liver cancer. Methods A total of 210 patients with liver cancer treated by TACE interventional therapy in the hospital from June 2015 to August 2016 were enrolled in the study, and they were examined with DWI scan and MRI enhanced scan before operation and after operation respectively. Referring to the Response Evaluation Criteria In Solid Tumors(RECIST), the treatment outcomes were divided into effective group and ineffective group. Imaging findings of patients were observed before and after treatment, and imaging quantitative changes were compared between the two groups before and after treatment. Results In the 210 patients, a total of 260 lesions were detected, and the average diameter of tumors was about 7.56 cm. The imaging features of patients with liver cancer were typical before and after TACE. The ADC values of lesions in patients with liver cancer after operation were significantly higher than those before operation. The values of CER arterial phase and SIR arterial phase in patients with liver cancer after operation were significantly lower than those before operation(P<0.05). After operation, the ADC value of effective group was significantly larger than that of the ineffective group, but the CER arterial phase and SIR arterial phase were significantly smaller than those in the ineffective group(P<0.05). ConclusionDWI and its MRI enhanced scan can effectively assess the survival and necrosis of lesions in patients with liver cancer after TACE interventional therapy, which is of important reference value in evaluating the early curative effect and guiding the further treatment.更多还原