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[目的]探讨MR扩散加权成像(DWI)对肝癌经导管动脉化疗栓塞术(TACE)术后疗效的评估价值。[方法]搜集30例行TACE治疗的巨块型肝癌患者,于术前24～48h、术后24～48h、术后14～16d、术后30～32d(二次TACE术前)行DWI扫描,机器为西门子Espree1.5T核磁机,b值选300、600及800s/mm2,比较不同时间段瘤区组织的平均ADC值的变化。[结果]术后各组肝癌组织的ADC值较术前明显升高(P<0.05),术后14～16d病变ADC值最高,是肿瘤细胞液化、坏死高峰期。术后30～32dADC值下降,与二次TACE对比,肿瘤细胞都有不同程度的复发。二次TACE发现病变18处,MRI平扫及增强诊断相符率85.7%,DWI诊断相符率94.7%。不同b值图象分析,b值选600s/mm2时,图象较清晰,病变敏感性高。[结论]磁共振成像DWI对肝癌TACE术后肿瘤细胞残存、复发具有高敏感性、特异性,是肝癌TACE术后疗效评价的有效方法。
[Objective] To evaluate the value of MR diffusion-weighted imaging (DWI) in assessing the curative effect of transcatheter arterial chemoembolization (TACE) for hepatocellular carcinoma. [Methods] Totally 30 patients with giant hepatocellular carcinoma treated with TACE were enrolled in this study. The patients underwent DWI in 24-48 hours, 24-48 hours, 14-16 days, 30-32 days (before TACE) , The machine is Siemens Espree1.5T nuclear magnetic machine, b value of 300,600 and 800s / mm2 selected, comparison of tumor tissue at different time intervals the average ADC value changes. [Results] The ADC value of liver cancer tissue in each group was significantly higher than that before operation (P <0.05). The ADC value of the lesion in 14 ~ 16 days after operation was the highest, which was the peak of liquefaction and necrosis of tumor cells. After 30 ~ 32dADC value decreased, compared with the secondary TACE, tumor cells have varying degrees of recurrence. Secondary TACE found lesions 18, MRI scan and enhanced diagnosis consistent rate of 85.7%, DWI diagnostic coincidence rate of 94.7%. Different b-value image analysis, b value of 600s / mm2 election, the image is more clear, high sensitivity lesions. [Conclusion] DWI is highly sensitive and specific to the residual and recurrence of TCC in patients with hepatocellular carcinoma. It is an effective method to evaluate the curative effect of TACE after liver cancer.