动态弥散加权成像对HCC的TACE术疗效评价的临床应用-论文.pdf

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1、医学影像学杂志2014年第24卷第3期JMedImagingVo1．24No．32014动态弥散加权成像对HCC的TACE术疗效评价的临床应用侯红军，许祖闪，万绪明(山东省威海市文登中心医院影像科山东威海264400)【摘要】目的探讨动态弥散加权成像对HCC的TACE术疗效评价的临床应用价值。方法对确诊为HCC的46例患者在TACE治疗前1～3天、6h、24h、1个月、3个月采用平扫TwI、FSTzWI、DWI扫描，术前诊断及术后1～3个月复查均行FSTwI动态增强扫描，DWI序列中弥散梯度因子(b

2、值)分别取600、800、】000s／ram，测量ADC值，并与血管造影对比。结果肿瘤的ADC值在TACE术后较术前升高，术前与术后1个月平均ADC值比较，差异有统计学意义。疗效良好的癌灶术后6hADC值明显减低，术后24h至术后1、3个月，ADC值呈上升趋势；疗效中等的癌灶术后6hADC值不均匀减低，术后24h始至术后1、3个月ADC值呈不均匀上升趋势；疗效差的癌灶术后6hADC值无明显变化，术后24h始至术后1、3个月ADC值呈不均匀轻度降低。结论动态DWI对HCC的TACE术疗效评估有重要的临

3、床应用价值。【关键词】弥散加权成像；ADC值；肝动脉灌注化疗栓塞术；磁共振成像中图分类号：R445．2；R735．7文献标识码：A文章编号：1006-9011(2O103—0395—04Theclinicalapplicationofdynamicdiffusion-weightedimaginginevaluatingthetreatmentofHCCafterTACEH0UHong-jan，XUZu—shan，WANXu—mingDepartmentofRadiology，WendengCent

4、erHospitalofWeihaiCity，ShandongProvince，Wendeng264400，P．R．China[Abstract]ObjectiveToexploretheclinicalvalueoftranscatheterarterialchemoembolizationintreatmentofprimaryhepatocellularcarcinomawithdynamicdiffusion-weightedimaging．MethodsForty-sixpatientsd

5、iagnosedwithHCCwhounderwentTACEwereassessed．TheMRIv~ascarriedoutat1-3dayspre—TACEandat6hours，24hours，1monthand3monthspost—TACErespectivelyandthesequenceincludedunenhancedandcontrast—enhancedTl—weightedimaging，FST2一weightedimaginganddiffusionweightedima

6、ging，fortheDWI，thediffusiongradientfactor(bvalue)weretaken600，800，1000s／mmrespectively，thecorrespondedADCvaluesweremeasuredandcomparedwithangiography．ResultsThemeanADCvaluesofHCCsafterTACEincreasedthanpreoperation，therewasstatisticallysignificancebetwe

7、enthedifferenceofmeanADCvaluesofpreandonemonthpost—TACE．ForthosewithgoodresponsetoTACE，theADCvaluesignificantlyreducedinsixhoursaftersurgerythendisplayedatendencyofrisingin24hoursand1——3monthsaftersur—-gery；forthosewithmoderateresponsetOTACE，theADCvalu

8、ereducedinconsistentlyinsixhoursanddisplayednon—U—niformlyascensionin24hoursand1～3monthsaftersurgery，whileforthosepoorresponsetoFACE，theADCvaluehadnosignificantchangesinsixhoursanddecreasedslightlyandinhomogeneouslyin24hoursand1～3months