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目的探讨3.0 T MR动态增强扫描定量参数在肝癌经导管肝动脉化疗栓塞术(TACE)术后疗效评估中的应用价值。方法用3.0 T MR对经穿刺证实的24例肝癌患者分别于TACE术前2~4天,术后1个月及3个月进行动态增强扫描,影像学测量肿瘤横轴位最长径,以及肝癌TACE术前、术后动态增强扫描定量参数:容量转运常数(Ktrans),速率常数(kep),血管外细胞外间隙容积百分比(Ve),并应用SPSS 19.0软件进行统计学分析。结果 (1)以实体瘤疗效评价标准(RECIST)为标准,将治疗结果分为有效组18个,无效组6个。(2)以RECIST为评估标准时,治疗前有效组与无效组间Ktrans值具有统计学差异。(3)在肝癌TACE术后,RECIST评估标准中的有效组与无效组间Ktrans值、kep值在治疗前与第1个月后复查、治疗前与第3个月后复查变化差异均具有统计学意义。结论以RECIST标准评估疗效时,治疗前Ktrans值具有预测作用,MRI动态增强扫描可以无创性检测体内肿瘤的血流灌注信息,对肝癌TACE术后疗效评估具有可行性,定量参数Ktrans、kep可以有效评估治疗后疗效,使治疗疗效的评估更为客观真实。
Objective To investigate the value of 3.0 T MR dynamic contrast-enhanced scanning in assessing curative effect of transcatheter arterial chemoembolization (TACE) after liver cancer. Methods Twenty-four patients with hepatocellular carcinoma proved by puncture were subjected to dynamic contrast-enhanced scanning 2 to 4 days, 1 month and 3 months after TACE respectively with 3.0 T MR. The longest diameter of the tumor was measured by imaging. Quantitative parameters: Ktrans, kep, and extra-vascular extracellular space volume (Ve) were measured before and after TACE in patients with hepatocellular carcinoma. SPSS 19.0 software was used for statistical analysis. Results (1) According to the criteria of RECIST, the treatment results were divided into 18 effective groups and 6 invalid groups. (2) When RECIST was used as the evaluation criterion, the Ktrans values between the effective group and the ineffective group before treatment were statistically different. (3) After TACE of liver cancer, Ktrans value and kep value between the effective group and the ineffective group in RECIST evaluation criteria were reviewed before and 1 month after treatment, and the differences between the two groups before and after 3 months of treatment were statistically significant Significance of learning. Conclusions The Ktrans value predicts the effect of RECIST before treatment. The dynamic contrast-enhanced MRI can detect the in vivo tumor perfusion information non-invasively. It is feasible to evaluate the curative effect of TACE for liver cancer. The quantitative parameters Ktrans and kep are effective Evaluate the curative effect after curative treatment, make curative effect evaluation more objective and true.