ADC值在肝癌经导管动脉化疗栓塞术后疗效评价中的价值初探

Preliminary Study of Apparent Diffusion Coefficient in the Evaluation of Therapeutic Effect of Transcatheter Arterial Chemoembolization for Hepatocellular Carcinoma

目的:探讨ADC值在肝癌经导管动脉化疗栓塞术(TACE)后疗效评价中的应用价值。方法:15例经导管动脉化疗栓塞后行Ⅱ期切除的肝细胞癌患者,术前进行磁共振扩散成像,对其ADC值与肿瘤病理特征进行相关对照分析。结果:肿瘤成活区与坏死区ADC值分别为(1.42±0.16)×10-3mm2/s、(1.58±0.18)×10-3mm2/s,两者之间差异有统计学意义(t=2.618,P<0.05)。不同病理分化程度的肿瘤成活区ADC值差异有统计学意义(t=-2.646,P<0.05),肿瘤的ADC值与其病理分化程度存在负相关(r=-0.607,P<0.05)。不同坏死程度的整个肿瘤ADC值差异有统计学意义(χ2=7.236,P<0.05),整个肿瘤的ADC值与其坏死程度存在显著正相关(r=0.689,P<0.01)。结论:ADC值能较好地鉴别肝癌成活、坏死组织,并在一定程度上反映肿瘤分化及坏死情况,在肝癌TACE术后疗效评价中具有一定的应用价值。

Objective：To investigate the clicical value of apparent diffusion coeffecient （ADC） in the evaluation of therapeutic effect of transcatheter arterial chemoembolization （TACE） for hepatocellular carcinoma （HCC）. Methods：Diffusion weighted imaging （DWI） were performed in 15 patients with HCC which were treated by TACE before Ⅱ-phase surgery were undertaken. The ADC values were analyzed and correlated with pathological findings after surgery. Results：The ADC values of viable tumor and necrosis within tumor were （1.42±0.16） × 10^3mm^2/s and （1.58±0.18） × 10^3mm^2/s, respectively and significant statistical difference of ADC values was existed （t= 2.618,P〈0.05）. The ADC values of highly and poorly differentiated viable tumor showed significant statistical difference （t=-2. 646, P〈0.05）. Negative correlation was observed between tumor differentiation and ADC values （r= 0. 607, P〈0.05）. The ADC values of the whole tumor with different degree of necrosis showed significant statistical difference （x^2 = 7. 236, P〈0.05）. Significant positive correlation was observed between the degree of tumor necrosis and ADC values （r= 0. 689, P〈0.01 ）. Conclusion ： The viable and necrotic areas of HCC after TACE could be differentiated by the ADC values which also in certain degree reflected the tumor cell differentiation and the degree of necrosis. The ADC values played an important role in evaluating the therapeutic effect of TACE for HCC.