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目的探讨磁共振功能成像指标评价肝动脉化疗栓塞(TACE)治疗肝细胞肝癌疗效的可行性。方法搜集行肝动脉化疗栓塞术治疗的30例原发性肝细胞肝癌患者,对治疗前后磁共振功能成像参数进行比较分析。结果治疗后磁共振波谱(MRS)参数胆碱/脂质(Cho/Lip)峰下面积比值较术前降低,治疗前后比较有显著性差异(P<0.05)。治疗后动态增强MRI(DCE-MRI)灌注定量指标容积转移常数(K~(trans))、组织间隙-血浆速率常数(k_(ep))、肝动脉灌注指数(HPI)较术前降低,而表观扩散系数(ADC)值较术前增高,治疗前后比较差异有统计学意义(P<0.05)。K~(trans)降低率与肿瘤坏死率呈正相关(r=0.751,P<0.01)。术前和术后肿瘤ADC值和Cho/Lip比值均呈负相关,r值分别为-0.386、-0.407(P<0.05)结论磁共振功能成像指标ADC值、k_(ep)值、HPI、Cho/Lip峰下面积比值对于评价TACE治疗肝癌疗效有一定价值,Ktrans值有较高价值,在肿瘤治疗疗效预测中有较大意义。
Objective To investigate the feasibility of using magnetic resonance imaging to evaluate the efficacy of transcatheter arterial chemoembolization (TACE) in the treatment of hepatocellular carcinoma. Methods Thirty patients with primary hepatocellular carcinoma treated with transcatheter arterial chemoembolization were enrolled in this study. The parameters of MR imaging before and after treatment were compared. Results The peak area ratio of Cho / Lip in MRS was lower than that before operation after treatment, and there was significant difference before and after treatment (P <0.05). After treatment, the volumetric transfer constant (K trans), tissue interstitial-plasma velocity constant (k ep) and hepatic arterial perfusion index (HPI) in dynamic enhanced MRI (DCE-MRI) Apparent diffusion coefficient (ADC) value increased compared with preoperative, before and after treatment, the difference was statistically significant (P <0.05). There was a positive correlation between K (trans) reduction rate and tumor necrosis rate (r = 0.751, P <0.01). The ADC value and Cho / Lip ratio of tumor before and after operation were negatively correlated, r values were -0.386, -0.407 respectively (P <0.05) Conclusion The ADC value, k ep value, HPI, Cho / Lip peak area ratio for the evaluation of the efficacy of TACE in the treatment of liver cancer has some value, Ktrans value has high value, the prognosis of the treatment of cancer is of great significance.