MR弥散加权成像评价肝癌介入结合平肝汤治疗的疗效

To evaluate the clinical effect with MR diffusion weighted imaging(DWI) of the interventional therapy combined with Ping Gan Tang for hepatocellular carcinoma HCC

目的应用MR弥散加权成像(DWI)研究肝癌介入结合平肝汤治疗肝癌的临床效果。方法将肝癌介入术后患者随机分组,分别为试验组和对照组各30例。试验组予肝癌介入手术结合平肝汤治疗,于介入术后第3天开始每天口服中药,第3和33天分别行DWI扫描。对照组在介入治疗后第3和33天行DWI扫描。对比分析2组治疗前后表观扩散系数(ADC)值的变化、肝区疼痛的改变等。结果试验组DWI扫描,当b值为300、500、700时治疗前后的ADC值差异有统计学意义(P<0.05),平肝汤治疗后肝癌组织的ADC值高于治疗前。对照组DWI复查,ADC值前后无明显变化。试验组和对照组疼痛感减轻或消失有效率分别约为85%和73%。结论介入治疗能够为肝癌的治疗提供帮助,而平肝汤与其协同治疗在减痛、提高生存质量等方面能有更好的治疗效果。DWI扫描的ADC值能够反映介入及平肝汤治疗后肿瘤组织内部的变化情况,为介入并用中药治疗提供评价。

Objective To study the clinical effect with MR diffusion weighted imaging(DWI)of the interventional therapy combined with Ping Gan Tang for hepatocellular carcinoma(HCC).Methods according to the principle of randomization,the 60 cases of interventional therapy of HCC were divided into in the experimental and the control group respectively.The experimental group was treated with interventional therapy combined with Ping Gan Tang.From the third days of interventional therapy,Ping Gan Tang was orally taken every day,and DWI was performed on third days and thirty-third days respectively.In the control group,DWI was performed on the third and thirty-third days after simple interventional therapy.The several changes including the value of apparent diffusion coefficient(ADC),the pain of the hepatic area in the 2 groups were compared and analyzed before and after treatments.Results In the experimental group,when b value of DWI taken 300,500 and 700,there was a significant difference in the ADC value before and after treatment(P<0.05).The ADC value of HCC after treatment was higher than that before treatment.There was no significant changes in the value of ADC before and after DWI in the control group.The effective rate of pain relief or disappear in the experimental group and the control group was about 85%and 73%respectively.Conclusion The interventional therapy can provide help for the treatment of HCC,while the combination of interventional therapy and Ping Gan Tang has better effect in reducing pain and improving the quality of life.The ADC value of DWI can reflect the changes within the tumor tissue after the interventional therapy combined with Ping Gan Tang and provide an evaluation for interventional therapy combined with traditional Chinese medicine.