HCC介入治疗疗效预期及评估的MRI多模态研究

MRI Multimodal Study on the Expectation and Evaluation of HCC Interventional Therapy

目的回顾性分析原发性肝癌介入治疗患者术后表观弥散系数和门静脉期增强信号强度的变化,探究多模态MRI对于原发性肝癌介入治疗疗效的评估作用。方法选择于2014年3月到2015年3月来我院就诊的原发性肝癌患者共50例,分别在治疗前,治疗后1个月,治疗后6个月对患者行核磁共振扫描,根据对比治疗前后患者表观弥散系数和门静脉期增强信号强度变化对患者治疗效果进行评价。结果 HCC介入治疗前病灶区域表观弥散系数值为(1.23±0.37)×10^(-3)mm^2,而经过治疗后其平均值为(1.93±0.53)×10^(-3)mm^2,两组数据存在显著差异(P<0.05);治疗前病灶门静脉期增强信号强度均值为(59±19)%,而治疗后为(47±21)%,与治疗前相比出现显著下降(P<0.05)。治疗后6个月进行随访,对病灶疗效进行分类,共81个病灶,其中部分缓解为34个,稳定病灶为36个,进展病灶为11个;利用非参数ROC曲线分析发现各疗效组的表观弥散系数值和门静脉期增强信号强度值改变情况存在显著差异(P<0.05)。结论 MRI多模态研究可以作为HCC介入治疗后疗效预期及评估的生物学指标,通过表观弥散系数和门静脉期增强信号强度的改变程度可以预测疗效。

Objective To analyze the changes of the apparent diffusion coefficient and the signal intensity of portal vein in patients with primary hepatocellular carcinoma （HCC） retrospectively, and to explore the effect of multimode MRI on the efficacy of interventional therapy for primary liver cancer. Methods A total of 50 patients with primary hepatocellular carcinoma who were treated in our hospital from March 2014 to March 2015 were enrolled in this study. the patients underwent nuclear magnetic resonance scan before, 1 month after treatment and 6 months after treatment,. Comparison of the apparent diffusion coefficient and the enhancement of signal intensity in the portal vein before and after treatment were evaluated. Results The apparent diffusion coefficient was （1.23±0.37）×10^-3mm^2 before the treatment of HCC, and the mean value was （1.93±0.53）×10^-3mm^2 after treatment. There was significant difference between the two groups （P〈0.05） The mean signal intensity of the portal vein was （59±19）% and （47±21）% after treatment, which was significantly lower than that before treatment （P 〈0.05）. 6 months after treatment, the efficacy of the lesion was classified, a total of 81 lesions, including some of the relief of 34, stable lesions of 36, the progress of 11 lesions, the use of nonparametric ROC curve analysis found that the efficacy of the table （P〈0.05）. There is a significant difference between the two groups （P〈0.05）. Conclusion MRI multimodal study can be used as an indicator of the efficacy and prognosis of HCC after interventional therapy. The effect of the therapy can be predicted by the degree of change of the signal intensity and the enhancement of signal intensity through the apparent diffusion coefficient and portal vein.