MRI影像学表现与经皮射频消融治疗肝癌疗效的关系

Relationship Between MRI Imaging Findings and Liver Cancer Efficacy of Percutaneous Radiofrequency Ablation

目的探讨核磁共振成像(MRI)影像学表现与经皮射频消融(RFA)治疗肝癌疗效的关系。方法选取我院2017年1月至2018年1月收治的50例肝癌患者开展回顾性分析,所有患者接受RFA治疗,并于RFA术前、术后24h及术后1个月、术后3个月进行MRI检查。依据改良实体瘤疗效评价标准及MRI影像学提示肿瘤直径变化制定疗效标准,术后3个月对所有患者行疗效评价,依据是否有效分为有效组及无效组,比较两组的血清热休克蛋白90α(HSP90α)及甲胎蛋白(AFP)水平、弥散系数(ADC)。结果RFA术后3个月,经影像学检查证实治疗有效人数为26例,治疗无效人数为24例;有效组的HSP90α、AFP水平下降更加显著(P<0.05);有效组的ADC值先升高后下降,差异具有显著性(P<0.05),无效组的ADC值无显著变化(P>0.05)。结论MRI的T1WI、T2WI及动态增强的信号变化能够反映肝癌RFA术后肿瘤坏死及残留情况,其对于RFA治疗肝癌的疗效评价具有一定参考价值。

Objective To explore the relationship between the imaging findings of magnetic resonance imaging(MRI)and the efficacy of radiofrequency ablation(RFA)in the treatment of liver cancer.Methods 50 patients with liver cancer admitted to our hospital from January 2017 to January 2018 were retrospectively analyzed.All patients were given RFA,and were treated with MRI before RFA and at 24 h,1 month and 3 months after operation.Efficacy standard was established according to the improved evaluation criteria of solid tumor efficacy and tumor diameter changes suggested by MRI imaging,and the efficacy of all patients was evaluated at 3 months after operation.According to whether efficacy was effective or not,the patients were divided into effective group and ineffective group.Serum heat shock protein 90α(HSP90α)and alpha fetoprotein(AFP)levels and diffusion coefficient(ADC)were compared between the two groups.Results At 3 months after RFA,the number of cases with effective treatment was 26 cases confirmed by imaging examination,and the number of cases with invalid treatment was 24 cases.The levels of HSP90αand AFP in effective group were decreased more significantly(P<0.05).The ADC value in effective group was increased first and then decreased(P<0.05),and there was no significant change in the ADC value om ineffective group(P>0.05).Conclusions T1 WI,T2 WI and dynamic enhanced signal changes of MRI can reflect the tumor necrosis and residual after liver cancer RFA,and they have certain reference value for the efficacy evaluation of RFA treatment of liver cancer.