3.0T MRI-DWI的ADC值对于TACE术后肿瘤活性的判断价值

Clinical study of the ADC value of 3.0T MRI-DWI for therapeutic evaluation in HCC after TACE

目的:探讨肝细胞肝癌(hepatocellular carcinoma,HCC)经导管动脉内化疗栓塞(transcatheter arterial ehemoembolization,TACE)后3.0T磁共振成像(magnetic resonance imaging,MRI)弥散加权成像(diffusion-weighted imaging,DWI)表观弥散系数(averaged diffusivity coefficient,ADC)值特征,评价3.0T MRI及ADC值在HCC TACE治疗后监测肿瘤变化的价值。方法:收集2017年1—6月南通大学第二附属医院医院HCC患者25例,所有患者分别于TACE术前、术后1个月进行MRI-DWI的检查,b值选择800 s/mm^2。分析TACE治疗后病灶不同区域ADC值特征。结果:25例病灶中,局部肿瘤残留或复发14例。b值为800 s/mm^2时术后残留肿瘤组织、坏死组织分别为(0.962±0.024)、(1.777±0.094)×10^(-3)mm^2/s,术后复发肿瘤组织于正常肝组织ADC值分别为(1.122±0.054)、(1.500±0.063)×10^(-3) mm^2/s,差异有统计学意义(P<0.05)。结论:3.0T MRI-DWI的ADC值可用于鉴别HCC TACE治疗后坏死组织与复发或残留肿瘤组织,为临床鉴别病变性质提供了一种新的诊断办法。

Objective:To analyze the value of3.0T magnetic resonance imaging(MRI)and diffusion-weight imaging(DWI)in detecting the pathological lesion feature of post-transcatheter arterial ehemoembolization(TACE)in hepatocellular carcinoma(HCC).The characteristics of the averaged diffusivity coefficient(ADC)value were studied to evaluate the changes before and after treatment.Methods:From January to June in2017,Twenty-five HCC patients in the Second Affiliated Hospital of Nantong University were enrolled to receive TACE.One month later,3.0T MRI and DWI(b=800s/mm2)were performed to measure the averaged diffusivity coefficient(ADC)values of different lesions.The ADC values of different lesions were analyzed.Results:Viable tumors occurred in14of25HCC patients after TACE.The ADC value of the tumor necrotic tissue was(1.777±0.094)×10-3mm2/s,with a significant difference to the data(0.962±0.024)×10-3mm2/s of residual tumor.The data(1.122±0.054)×10-3mm2/s of recurrent tumor and the data(1.500±0.063)×10-3mm2/s of normal liver tissue were significantly different(P<0.05).Conclusion:The ADC values of3.0T MRI-DWI can be used to identify the necrosis tissue,residual and recurrent tumor tissue,which provides a new diagnostic method for clinical identification of pathological changes in HCC after TACE.