磁共振波谱早期评估局部热消融肝癌疗效的初步研究

Preliminary study of proton magnetic resonance spectroscopy in evaluation of the early response of hepatocellular carcinoma to local thermal ablation

目的探讨磁共振波谱(MRS)早期评估热消融肝癌疗效的价值。方法 17例疑为肝细胞癌(HCC)并接受热消融治疗患者的17个病灶于消融前后行MRS检查。测量其中HCC消融前后的胆碱峰(Cho)、脂峰(Lip)及水峰(Water)的峰下面积和Cho与Lip的比值(Cho/Lip)。结果 MRS成功率为70.6﹪,HCC消融前的Cho、Lip、Water及Cho/Lip依次为8.06×104,9.55×106,5.88×107,0.02;消融后为0,3.61×106,5.89×107,0。Cho、Cho/Lip在消融前后的差异均有统计学意义(P<0.05),Water、Lip之间的差异无统计学意义(P>0.05)。结论 MRS用于评价肝脏病灶具备技术可行性,能够发现消融前后HCC的代谢变化,在早期评估消融疗效方面有潜在价值。

Objective To investigate the efficiency of proton magnetic resonance spectroscopy in monitoring the early therapeutic response of hepatocellular carcinoma(HCC) to local thermal ablation.Methods 17 patients who were highly suspected as HCC were enrolled.17 nodules of all patients received MRS before and after local thermal ablation.The area under curve(AUC) of choline,lipid and water resonance peaked at 3.2 ppm,1.3 ppm and 4.7 ppm of HCCs and the choline-to-lipid ratio(Cho/Lip) were measured.Changes in choline,lipid,water and cho/lip before and after ablation were analyzed.Results The technical success rate for MRS was 70.6﹪.The median peak AUC of choline,lipid,water and cho/lip in 9 HCCs were 8.06×104,9.55×106,5.88×107,0.02 before ablation and 0,3.61×106,5.89×107,0 after ablation respectitvely.Significantly differences were observed between the pre-ablation and post-ablation choline and cho/lip peak areas(P < 0.05),whereas no significant differences between the pre-ablation and post-ablation peak areas of lipid and water was observed(P > 0.05).Conclusion MRS is technically feasible for the evaluation of focal hepatic lesions and has potential value in the detection of early metabolite changes in HCC after local thermal ablation.