本文選題：結(jié)腸癌肝轉(zhuǎn)移瘤　切入點：經(jīng)導(dǎo)管動脈化療栓塞術(shù)　出處：《介入放射學(xué)雜志》2016年06期 　論文類型：期刊論文

【摘要】：目的探討結(jié)腸癌肝轉(zhuǎn)移瘤經(jīng)導(dǎo)管動脈化療栓塞(TACE)治療前后動態(tài)對比增強(qiáng)磁共振成像(DCE-MRI)各定量參數(shù)的變化及其對預(yù)后評估的價值。方法對21例經(jīng)病理證實為低分化腺癌的結(jié)腸癌肝轉(zhuǎn)移患者分別于TACE術(shù)前及術(shù)后進(jìn)行常規(guī)MRI和DCE-MRI掃描。以兩腔室模型為基礎(chǔ),計算出定量血流動力學(xué)參數(shù)(K~(trans)、K_(ep)、V_e)。比較TACE術(shù)前、術(shù)后各參數(shù)的變化;分別探討患者近期療效與TACE術(shù)后DCE-MRI各項參數(shù)的相關(guān)性;并比較不同預(yù)后患者TACE術(shù)后各參數(shù)的差別。結(jié)果 TACE術(shù)后腫瘤組織的K~(trans)、K_(ep)及V_e值呈下降趨勢,且術(shù)前術(shù)后差別有統(tǒng)計學(xué)意義。DCE-MRI各項參數(shù)與CEA、CA125、CA199和CA242值無明顯相關(guān)性。術(shù)后近期療效評估示完全緩解3例(14.3%),部分緩解11例(52.4%),總有效率(RR)66.7%,疾病控制率(DCR)90.5%。其中RR、PCR均與術(shù)后K~(trans)值呈正相關(guān)(r=0.526,P=0.005;r=0.557,P=0.006),但與K_(ep)、V_e值無明顯相關(guān)性。結(jié)論結(jié)腸癌肝轉(zhuǎn)移瘤TACE治療前后DCE-MRI各定量血流動力學(xué)參數(shù)變化顯著,術(shù)后腫瘤組織中的K~(trans)值可作為結(jié)腸癌肝轉(zhuǎn)移TACE治療早期療效評估指標(biāo),為結(jié)腸癌肝轉(zhuǎn)移瘤個體化治療和治療方案的修正提供依據(jù),其遠(yuǎn)期療效與DCE-MRI定量參數(shù)的相關(guān)性需進(jìn)一步深入研究。
[Abstract]:Objective to investigate the changes of quantitative parameters of DCE-MRI before and after transcatheter arterial chemoembolization (TACEE) of hepatic metastases of colon cancer and their prognostic value. Methods 21 cases with pathologically proved low differentiation were studied. Conventional MRI and DCE-MRI scans were performed before and after TACE in patients with liver metastasis of colon cancer from adenocarcinoma. To calculate the quantitative hemodynamic parameters and to compare the changes of the parameters before and after TACE, and to explore the correlation between the short-term curative effect and the parameters of DCE-MRI after TACE. Results the tumor tissue of TACE patients showed a decreasing trend of KT / KAP and V\ + +\\\%. There was no significant correlation between the parameters of DCE-MRI and the values of CA125CA199 and CA242 before and after operation. The short-term curative effect evaluation showed complete remission in 3 cases and partial relief in 11 cases. The total effective rate was 66.7%, and the disease control rate was 90.5%. There was a positive correlation between the value of KG translocation and the value of TACE. Conclusion the changes of hemodynamic parameters of DCE-MRI were significant before and after TACE treatment, but there was no significant correlation between the value of KG and the value of Ve in patients with hepatic metastasis of colon cancer before and after TACE treatment, but there was no significant correlation between the value of KG and the value of Ve in patients with colon cancer liver metastases before and after TACE treatment. The value of KT in tumor tissue after operation can be used as an index to evaluate the early curative effect of TACE in the treatment of liver metastasis of colon cancer, and to provide basis for individualized treatment and revision of treatment scheme for liver metastases of colon cancer. The relationship between the long-term effect and the quantitative parameters of DCE-MRI needs further study.
【作者單位】： 南京軍區(qū)南京總醫(yī)院醫(yī)學(xué)影像科;
【基金】：國家自然科學(xué)基金(81471632)
【分類號】：R735.35;R445.2

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