發(fā)布時間：2018-08-13 16:56

【摘要】：目的探討磁共振功能成像指標評價肝動脈化療栓塞(TACE)治療肝細胞肝癌療效的可行性。方法搜集行肝動脈化療栓塞術治療的30例原發(fā)性肝細胞肝癌患者,對治療前后磁共振功能成像參數(shù)進行比較分析。結果治療后磁共振波譜(MRS)參數(shù)膽堿/脂質(Cho/Lip)峰下面積比值較術前降低,治療前后比較有顯著性差異(P0.05)。治療后動態(tài)增強MRI(DCE-MRI)灌注定量指標容積轉移常數(shù)(K~(trans))、組織間隙-血漿速率常數(shù)(k_(ep))、肝動脈灌注指數(shù)(HPI)較術前降低,而表觀擴散系數(shù)(ADC)值較術前增高,治療前后比較差異有統(tǒng)計學意義(P0.05)。K~(trans)降低率與腫瘤壞死率呈正相關(r=0.751,P0.01)。術前和術后腫瘤ADC值和Cho/Lip比值均呈負相關,r值分別為-0.386、-0.407(P0.05)結論磁共振功能成像指標ADC值、k_(ep)值、HPI、Cho/Lip峰下面積比值對于評價TACE治療肝癌療效有一定價值,Ktrans值有較高價值,在腫瘤治療療效預測中有較大意義。
[Abstract]:Objective to evaluate the feasibility of hepatic artery chemoembolization (TACE) in the treatment of hepatocellular carcinoma (HCC). Methods 30 patients with primary hepatocellular carcinoma treated by transcatheter arterial chemoembolization (TACE) were collected and compared with the parameters of Mr functional imaging before and after treatment. Results after treatment, the ratio of choline / lipid (Cho/Lip) subpeak area of (MRS) was significantly lower than that before and after treatment (P0.05). After treatment, the dynamic enhanced MRI (DCE-MRI) perfusion quantitative index volume transfer constant (K ~ (trans),) interstitial plasma rate constant (K _ (ep),) hepatic artery perfusion index (HPI) was decreased, while the apparent diffusion coefficient (ADC) was increased. The difference before and after treatment was statistically significant (P0.05). The decrease rate of K- (trans) was positively correlated with the rate of tumor necrosis (r = 0.751a, P0.01). There was a negative correlation between preoperative and postoperative tumor ADC value and Cho/Lip ratio (P 0.05). Conclusion the ADC value and (ep) value of Mr functional imaging index and the ratio of area under HPICho-Lip peak are valuable in evaluating the curative effect of TACE in the treatment of hepatocellular carcinoma. It has great significance in predicting the curative effect of tumor therapy.
【作者單位】： 浙江大學醫(yī)學院附屬第二醫(yī)院放射科;浙江省紹興市人民醫(yī)院放射科;
【基金】：浙江省中醫(yī)藥科技研究基金項目(編號:2012ZB157) 紹興市公益性應用計劃項目(編號:2013D10039) 浙江省醫(yī)藥衛(wèi)生一般研究計劃項目(編號:201465315)
【分類號】：R445.2;R735.7

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