摘要
目的研究体素内不相干运动扩散加权成像(IVIM-DWI)技术评估经动脉化疗栓塞(TACE)治疗肝细胞肝癌(HCC)疗效的价值。方法HCC患者120例,于TACE治疗前1周与治疗1个月时进行磁共振(MRI)常规序列、DWI序列及IVIM序列扫描检查;治疗1个月时参照改良的实体瘤疗效评价将患者分为稳定组(完全缓解、部分缓解、疾病稳定)和进展组(疾病进展),记录所有HCC患者及两组HCC患者组的TACE治疗前1周与治疗1个月时IVIM参数[灌注参数表观扩散系数(ADC)、真实扩散系数(D)、灌注相关扩散系数(D)值、灌注分数(f)];绘制受试者特征工作曲线(ROC曲线)分析IVIM-DWI参数对预后的评估价值。结果TACE治疗后,两组患者ADC、D值水平均高于治疗前,D、f值低于治疗前,差异有统计学意义(P<0.05);稳定组患者治疗前的ADC、D值和治疗后的D、f值均高于进展组,治疗后的D值低于进展组,差异有统计学意义(P<0.05);治疗前ADC、D值和治疗后D、f值评估TACE治疗HCC疗效的ROC曲线下面积分别为0.701、0.759、0.609、0.644,治疗前或治疗后各项参数联合评估的曲线下面积为0.809、0.667。结论HCC患者TACE治疗前IVIM-DWI检查参数ADC、D值和治疗后D、f值均能较好评估疗效,且治疗前各项参数联合的评估价值最高。
Objective To assess the value of intravoxel incoherent motion-diffusion weighted imaging(IVIM-DWI)in evaluating the therapeutic efficacy of transarterial chemoembolization(TACE)for hepatocellular carcinoma(HCC).Methods A total of 120 patients with HCC were examined by conventional magnetic resonance imaging(MRI),DWI,and IVIM at 1 week before treatment and at 1 month for treatment.According to the modified solid tumor efficacy evaluation,the patients at 1 month for treatment were divided into the stable group(complete remission,partial remission,stable disease)and progression group(disease progression).At 1 week before treatment and at 1 month for treatment,the patients'IVIM parameters including apparent diffusion coefficient(ADC),true diffusion coefficient(D),perfusion-related diffusion coefficient(D)value,perfusion fraction(f)were recorded.Receiver characteristic operating curve(ROC curve)was plotted to analyze the prognostic accuracy of IVIM-DWI parameters.Results After TACE treatment,ADC,and D values were higher than those before treatment,while the D and f values were lower than those before treatment(P<0.05).ADC and D values in stable group before treatment as well as D and f values after treatment were higher than those in progression group,while the D values after treatment were lower than those in progression group(P<0.05).The area under the ROC curve(AUC)of ADC,D values before treatment,and D,f values after treatment were 0.701,0.759,0.609,and 0.644,respectively.AUC was used to evaluate prediction efficacy of these parameters.The AUC of the combined parameters before and after treatment was 0.809 and 0.667,respectively.Conclusion IVIM-DWI-derived ADC and D values before TACE treatment and D and f values after TACE treatment are good parameters to evaluate the curative effect of TACE.The prediction accuracy of the combination of these parameters before treatment is the highest.
作者
肖伟
张宏伟
黄丹
陈匡荣
陈泽莉
张莉
XIAO Wei;ZHANG Hongwei;HUANG Dan;CHEN Kuangrong;CHEN Zeli;ZHANG Li(Department of Oncology,the First People's Hospital of Ziyang City,Ziyang 641300,Sichuan,China)
出处
《贵州医科大学学报》
CAS
2021年第12期1463-1467,共5页
Journal of Guizhou Medical University
基金
四川省卫生和计划生育委员会科研课题普及应用项目(16PJ594)。
关键词
肝细胞肝肿瘤
体素内不相干运动扩散加权成像
动脉化疗栓塞
疗效
评估价值
hepatocellular carcinoma(HCC)
intra-voxel incoherernt motion diffused-weighted imaging(IVIM-DWI)
transarterial chemoembolization(TACE)
efficacy
evaluation
