弥散成像对肝癌伽玛刀疗效评价的初步研究

A Preliminary Study on Assessment of Therapeutic Efficacy of Gamma Knife Radiosurgery in Treatment of Hepatic Carcinoma Based on Diffusion Weighted Imaging

目的:通过弥散加权成像评价肝癌患者伽玛刀治疗效果,为临床早期评价疗效提供客观依据。方法:72例肝癌患者(原发肝癌62例,转移性肝癌10例)共77个癌灶,分别于治疗前、治疗后3天、治疗后3个月行MR检查,包括常规序列及DWI扫描。以治疗后体积变化分为有效组、稳定组、进展组。比较治疗前及治疗后3天肿瘤中心及边缘肝组织的ADC值变化。结果:有效组及稳定组肿瘤中心ADC值治疗前后存在统计学差异,进展组无明显统计学差异;肿瘤周边组织的ADC值在三组前后均有统计学差异;进展组治疗前ADC值明显高于有效组及稳定组。结论:ADC值能够反映肝癌伽玛刀治疗后肿瘤组织内部的病理变化,为早期疗效的判断提供量化指标。

Purpose： In order to assess the therapeutic effect of Gamma knife radiosurgery for hepatic carcinoma in early stage, diffusion weighted imaging technique was used in patients with hepatic carci- noma after Gamma Knife radiosurgery. Methods： Seventy two patients with hepatic carcinomas （62 primary carciomas and 10 metastases）, who had 77 lesions totally, were treated with Gamma Knife ra diosurgery. All patients received MR examinations, including conventional sequences and DWI scan be fore, three days after and three months after radiotherapy. The patients were divided into three groups： relieved group, stable group and progressing group based on the changes of tumor size during treat ment.ADC values in the area of tumor center and boundaries were measured and compared. Results： In relieved group and stable group, after Gamma Knife radiosurgery, ADC values of tumor center were statistically different from those obtained before treatment. However, in progressing group, there was no statistically significant difference between pre - treatment and post - treatment measurements. In all groups, pre treatment and post- treatment ADC values of tumor boundaries were statistically differ ent. Especially, ADC values of the progressing group were significantly higher than those of the other two groups. Conclusion： After Gamma Knife radiosurgery, ADC values can reflect pathological changes in tumor tissue and provide quantitv indicators to assess the theraneutic effect in early stage