【摘要】：目的：探討應(yīng)用釓塞酸二鈉(Gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid, Gd-EOB-DTPA)增強(qiáng)核磁共振(Magnetic resonance imaging, MRI)掃描評價(jià)肝細(xì)胞癌(Hepatocellular carcinoma, HCC)行經(jīng)導(dǎo)管動脈灌注化療栓塞(Transcatheter arterial chemoembolization, TACE)術(shù)后局部肝功能損傷的價(jià)值。 方法：對29例HCC的患者于TACE術(shù)后3-5天以及隨訪1-2月后行MR掃描,測量平掃和Gd-EOB-DTPA增強(qiáng)后20分鐘(肝細(xì)胞期)腫瘤周邊(3厘米以內(nèi))組織以及正常肝組織的信噪比值(Signal to noise ratio, SNR),將二者進(jìn)行對比。同時(shí)將可能的影響因素,如患者年齡、性別、腫瘤直徑、腫瘤血供情況、Chind-Pugh分級和碘油栓塞量與結(jié)果進(jìn)行多因素相關(guān)分析。 結(jié)果：TACE術(shù)后3-5天,平掃腫瘤周邊組織的SNR值與正常肝組織的SNR差異無統(tǒng)計(jì)學(xué)意義(t=1.341, P=0.191), Gd-EOB-DTPA增強(qiáng)后20分鐘腫瘤周邊組織的SNR值明顯低于正常肝組織的SNR值(t=3.732,P0.001)。TACE術(shù)后1-2月復(fù)查MRI,平掃腫瘤周邊組織的SNR值與正常肝組織的SNR值差異無統(tǒng)計(jì)學(xué)意義(t=0.189,P=0.852); Gd-EOB-DTPA增強(qiáng)后20分鐘腫瘤周邊的SNR與正常肝組織的SNR值差異同樣無統(tǒng)計(jì)學(xué)意義(t=1.535,P=0.136)。局部肝功能損傷的程度與患者年齡、性別、腫瘤直徑、腫瘤血供情況、Chind-Pugh分級均無明顯相關(guān)性,碘油栓塞量是唯一影響局部肝功能損傷程度的因素。 結(jié)論：Gd-EOB-DTPA增強(qiáng)MRI掃描是一種有效評價(jià)肝癌TACE術(shù)后局部肝功能損傷的方法,對指導(dǎo)進(jìn)一步治療有著重要價(jià)值。圖6幅,表6個(gè),參考文獻(xiàn)45篇
[Abstract]:Objective: to investigate the evaluation of transcatheter arterial infusion chemoembolism (Transcatheter arterial chemoembolization,) in hepatocellular carcinoma (Hepatocellular carcinoma, HCC) by enhanced nuclear magnetic resonance (Magnetic resonance imaging, MRI) with disodium gadolinium citrate (Gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid, Gd-EOB-DTPA). TACE) the value of local liver function injury after operation. Methods: 29 patients with HCC were examined by MR at 3 to 5 days after TACE and 1-2 months after follow-up. The signal-to-noise ratio (SNR) (Signal to noise ratio, SNR), of peripheral tissues (less than 3 cm) and normal liver tissues (within 3 cm) were measured 20 minutes after Gd-EOB-DTPA enhancement. At the same time, the possible influencing factors, such as patient age, sex, tumor diameter, tumor blood supply, Chind-Pugh grade and iodized oil embolic volume, were analyzed by multivariate correlation analysis. Results: there was no significant difference in SNR between the surrounding tissues of the tumor and the normal liver tissue at 3 and 5 days after TACE (t 鈮，

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