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目的分析MRI评价碘油栓塞后沉积良好肝癌(HCC)患者肿瘤残存的价值。方法经TACE治疗后3~6月,CT扫描碘油沉积良好的25例HCC患者,1个月内同时行MRI常规扫描及DSA检查,以DSA和临床随访6个月以上结果为标准,分析MRI对肿瘤残存灶的评价效果。结果本组25例CT扫描无肿瘤残存的患者,MRI增强扫描发现14例存在肿瘤残存,其中1例可疑,DWI发现高信号而经DSA证实有肿瘤残存,而经DSA及6个月以上临床随访证实,16例患者有肿瘤残存。MRI随访诊断灵敏性为87.5%(14/16),漏诊率为(2/16),特异性为100%(9/9),符合率为92%((14+9)/25)。结论 TACE后碘油沉积良好的病灶中仍可能有肿瘤残存,MRI增强扫描结合DWI能更全面的评价TACE疗效。
Objective To evaluate the value of MRI in the evaluation of residual tumor in patients with well-preserved hepatocellular carcinoma (HCC) after iodized oil embolization. Methods Twenty-five patients with HCC with lipiodol deposition from March to June after TACE were treated with routine MRI scan and DSA within 1 month. DSA and clinical follow-up of 6 months or more were used as the standard to analyze MRI Evaluation of residual tumor lesions. Results Of the 25 patients who had no residual tumor after CT scan, there were 14 cases with residual tumor after MRI scan. One case was suspicious, the high signal was detected by DWI and the tumor was confirmed by DSA. After DSA and clinical follow-up of 6 months Confirmed that 16 patients had residual tumor. The sensitivity of follow-up MRI was 87.5% (14/16), the rate of missed diagnosis was (2/16), specificity was 100% (9/9), and the coincidence rate was 92% ((14 + 9) / 25). Conclusions Tumor remains in the well-preserved lesions of lipiodol after TACE. TACE can be more fully evaluated by MRI-enhanced MRI in combination with DWI.