摘要
目的分析3.0 TMR动态增强扫描(DCE-MRI)参数在肝癌(HCC)患者经导管肝动脉化疗栓塞(TACE)术后疗效评估中的应用价值。方法选取我院首次行TACE治疗的进展期HCC患者138例,入院后完善相关检查择期进行TACE治疗,分别于术前1周及术后1月时行MRI检查,定量分析获得以下参数容量运转常数(Ktrans)、速率常数(Kep)、血管外/细胞外间隙容积比(Ve)和增强曲线下初始面积(iAUC)。并作受试者工作特征曲线(ROC)计算曲线下面积(AUC)分析各参数对TACE疗效评估的价值。结果TACE术后1月评估结果显示,138例HCC患者中治疗有效103例,无效35例,有效率74.64%;术后1月有效组Ktrans、Kep和iAUC明显降低(P<0.05),无效组Kep明显降低(P<0.05),且有效组Ktrans、Kep和iAUC明显低于无效组(P<0.05);Ktrans、Kep和iAUC评估TACE疗效的敏感度分别为77.1%、80.0%、82.9%,特异度分别为76.7%、79.6%、62.1%,Cut-off值分别为0.735、1.235、17.580,AUC值分别为0.840、0.807、0.758。联合评估的敏感度及特异度为88.6%、83.5%,AUC值为0.939,其临床价值明显更高(P<0.05)。结论DCE-MRI参数Ktrans、Kep和iAUC用于评估TACE对进展期HCC治疗疗效具有较高临床价值,且其联合评估价值更好,结果更客观真实。
Objective To analyze the application value of parameters of 3.0 T MR dynamic-contrast enhancement magnetic resonance imaging(DCE-MRI)in evaluating curative effect of transcatheter arterial chemoembolization(TACE)for patients with hepatic carcinoma.Methods A total of 138 patients with advanced HCC who underwent TACE in our hospital for the first time were enrolled.After admission,relevant examinations were completed,and they underwent elective TACE.Before 1 week and after 1 month of surgery,MRI examination was performed.The quantitative analysis was performed to obtain following parameters:volume transfer constant(Ktrans),rate constant(Kep),extravascular extracellular space volume fraction(Ve)and initial area under the enhancement curve(iAUC).The receiver operating characteristic(ROC)curves were drawn to calculate area under ROC curves(AUC).The evaluation value of each parameter in curative effect of TACE was analyzed.Results After 1 month of TACE,evaluated results showed that among 138 HCC patients,there were 103 cases with effective treatment and 35 cases with ineffective treatment.The response treatment rate was 74.64%.After 1 month of surgery,Ktrans,Kep and iAUC were significantly decreased in the effective group(P<0.05),and Kep in the ineffective group was significantly decreased(P<0.05).Ktrans,Kep and iAUC in the effective group were significantly lower than those in the ineffective group(P<0.05).The sensitivities of Ktrans,Kep and iAUC were 77.1%,80.0%and 82.9%,respectively.The specificities of Ktrans,Kep and iAUC were 76.7%,79.6%and 62.1%,respectively.The cut-off values of Ktrans,Kep and iAUC were 0.735,1.235 and 17.580,respectively.The AUC of Ktrans,Kep and iAUC were 0.840,0.807 and 0.758,respectively.The sensitivity,specificity and AUC of their combination evaluation were 88.6%,83.5%and 0.939,respectively.The combined was significantly higher than single parameter alone(P<0.05).Conclusion Clinical value of DCE-MRI parameters of Ktrans,Kep and iAUC are of high for evaluating curative effect of TACE on advanced HCC.Their combined evaluation value is better,and results are more objective and true.
作者
高万春
李小军
陈金叶
刘凯
陈旭
向世兰
GAO Wan-chun;LI Xiao-jun;CHEN Jin-ye;LIU Kai;CHEN Xu;XIANG Shi-lan(Department of Radiology,Chongqing Qianjiang Central Hospital,Chongqing 409000,China)
出处
《实用医院临床杂志》
2020年第2期210-213,共4页
Practical Journal of Clinical Medicine
