【摘要】：目的探討磁共振功能成像指標(biāo)評(píng)價(jià)肝動(dòng)脈化療栓塞(TACE)治療肝細(xì)胞肝癌療效的可行性。方法搜集行肝動(dòng)脈化療栓塞術(shù)治療的30例原發(fā)性肝細(xì)胞肝癌患者,對(duì)治療前后磁共振功能成像參數(shù)進(jìn)行比較分析。結(jié)果治療后磁共振波譜(MRS)參數(shù)膽堿/脂質(zhì)(Cho/Lip)峰下面積比值較術(shù)前降低,治療前后比較有顯著性差異(P0.05)。治療后動(dòng)態(tài)增強(qiáng)MRI(DCE-MRI)灌注定量指標(biāo)容積轉(zhuǎn)移常數(shù)(K~(trans))、組織間隙-血漿速率常數(shù)(k_(ep))、肝動(dòng)脈灌注指數(shù)(HPI)較術(shù)前降低,而表觀擴(kuò)散系數(shù)(ADC)值較術(shù)前增高,治療前后比較差異有統(tǒng)計(jì)學(xué)意義(P0.05)。K~(trans)降低率與腫瘤壞死率呈正相關(guān)(r=0.751,P0.01)。術(shù)前和術(shù)后腫瘤ADC值和Cho/Lip比值均呈負(fù)相關(guān),r值分別為-0.386、-0.407(P0.05)結(jié)論磁共振功能成像指標(biāo)ADC值、k_(ep)值、HPI、Cho/Lip峰下面積比值對(duì)于評(píng)價(jià)TACE治療肝癌療效有一定價(jià)值,Ktrans值有較高價(jià)值,在腫瘤治療療效預(yù)測(cè)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(xué)醫(yī)學(xué)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(xiàng)目(編號(hào):2012ZB157) 紹興市公益性應(yīng)用計(jì)劃項(xiàng)目(編號(hào):2013D10039) 浙江省醫(yī)藥衛(wèi)生一般研究計(jì)劃項(xiàng)目(編號(hào):201465315)
【分類(lèi)號(hào)】：R445.2;R735.7

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