肝癌碘油栓塞后沉积良好患者的MRI随访临床研究

Value of MRI in assessing residual tumor of hepatocellular carcinoma in patients with accumulation deposition of lipiodol after TACE

目的分析MRI评价碘油栓塞后沉积良好肝癌（HCC）患者肿瘤残存的价值。方法经TACE治疗后3~6月,CT扫描碘油沉积良好的25例HCC患者,1个月内同时行MRI常规扫描及DSA检查,以DSA和临床随访6个月以上结果为标准,分析MRI对肿瘤残存灶的评价效果。结果本组25例CT扫描无肿瘤残存的患者,MRI增强扫描发现14例存在肿瘤残存,其中1例可疑,DWI发现高信号而经DSA证实有肿瘤残存,而经DSA及6个月以上临床随访证实,16例患者有肿瘤残存。MRI随访诊断灵敏性为87.5%（14/16）,漏诊率为（2/16）,特异性为100%（9/9）,符合率为92%（（14＋9）/25）。结论 TACE后碘油沉积良好的病灶中仍可能有肿瘤残存,MRI增强扫描结合DWI能更全面的评价TACE疗效。

Objective To Analysis residual tumor with MRI after transcatheter arterial chemoembolization（TACE） with accumulation deposition of lipiodol in HCC patients.Methods After TACE treatment for 3~6 months,CT scanning were preformed in 25 HCC patients with lipiodol accumulation deposition,and Residual tumors,revealed with MRI scan,were compared with the results of DSA and clinical follow-up 6 months.CT,MRI and DSA underwent routinely within one month,and Residual tumors were analyzed with MRI and DSA results.Results The group of 25 cases of CT scan in patients without residual tumor,enhanced MRI scan revealed residual tumor in14 cases,including1 cases suspect of residual tumor with DWI scan finding high signal,residual tumor was confirmed by subsequent DSA,while residual tumors in16 cases were confirmed by DSA and more than 6 months of clinical follow-up.The sensitivity of MRI follow-up diagnosis was 87.5%（14/16）,the rate of missed diagnosis for（2/16）,the specificity was 100%（9/9）,the coincidence rate is 92%（（14＋9） /25）.Conclusions Rresidual tumor may exist within original HCC lesions with accumulation deposition of lipiodol,MRI scanning may more comprehensive detect the viable tumor after TACE.