磁共振扩散加权成像表观扩散系数评估肝癌患者TACE疗效

Application of apparent diffusion coefficient values of magnetic resonance diffusion-weighted imaging to evaluate the therapeutic effect of TACE in patients with liver cancer

目的:观察分析磁共振扩散加权成像表观扩散系数(ADC)对肝癌患者经导管肝动脉栓塞术(TACE)后疗效的评估价值。方法:选取肝细胞癌患者52例,病灶共计79个,共计进行TACE161次,分别于治疗前、治疗后、治疗后1个月及治疗后3个月进行磁共振扩散加权成像,在各个阶段测定肝脏正常组织和肿瘤组织的ADC值,疗效评定标准分级为完全缓解(优良)、部分缓解(一般)和进展(差)。将所有患者分为优良组、一般组和进展组,对比分析患者治疗前后及随访中ADC值的变化情况。结果:治疗后肿瘤病灶ADC值为(1.48±0.16)×10^(-3)mm^2/s,显著高于正常肝组织的(1.22±0.15)×10^(-3)mm^2/s。治疗后肿瘤组织区域ADC值升高程度优良组最明显,一般组次之,进展组最小,优良组与一般组组间治疗前后肿瘤组织区域ADC值比较有统计学差异(P<0.05),组内比较无统计学差异(P>0.05)。治疗后1个月和3个月各组之间两两比较差异均有统计学意义(P<0.05),3组比较差异有统计学意义(P<0.05)。结论:ADC对肝癌患者TACE后疗效的评估有较好的参考价值。

Objective To analyze the value of apparent diffusion coefficient (ADC) values of magnetic resonance diffusion-weighted imaging (MR-DWI) in the evaluation of the therapeutic effect of transhepatic arterial chemoembolization (TACE) for liver cancer. Methods Atotal of 52 patients with hepatocellular carcinoma were enrolled in this study, with a total of 79 lesions and a total of 161 TACE treatments. MR-DWI was performed at different times (before treatment, after treatment, 1 month after treatment and 3 months after treatment). TheADC values of normal liver tissues and tumor tissues were measured before and after treatment. According to the efficacy evaluation criteria, the patients were classified into 3 groups, namely complete remission group, partial remission group and progression group. The changes of ADC values before and after treatment and during follow-up were analyzed. Results The ADC value of tumor lesions after treatment was (1.48±0.16)×10^-3 mm^2/s, significantly higher than (1.22±0.15)×10^-3 mm^2/s of normal liver tissues.After treatment, the increase ofADC value of the tumor tissue area wasmost obvious in complete remission group, followed by partial remission group and progression group. Statistical differences were found in the ADC value of tumor tissue area between complete remission group and partial remission group before and after treatment (P<0.05), while no statistical difference was found in the intra-group comparison (P>0.05). There were significant differences between any two groups at 1 month and 3 months after treatment (P<0.05), and the differences in the comparison among 3 groups has statistical significance (P<0.05). Conclusion TheADC value of magnetic resonance diffusion-weighted imaging provides a good reference value for the evaluation of chemotherapeutic efficacy of TACE in patients with liver cancer.