MRI对微波固化治疗肝癌疗效的评价

目的评价1.5TMRI平扫和动态增强对肝癌微波固化治疗后表现和疗效随访的价值。方法回顾性分析26例32个病灶肝癌微波固化治疗后MRI表现,并与AFP和DSA结果进行对照。结果微波固化治疗3天后的MRI平扫表现,T1WI呈相对高信号,T2WI呈相对低信号,病灶周围可见长T1,长T2水肿带。微波固化治疗1月后的MRI表现①单独行微波固化治疗的19个病灶以凝固性坏死为主,平扫T1WI呈相对等高信号,T2WI呈相对低信号或等信号,动态增强扫描无强化;②多种介入方法联合应用的5个病灶,特别是与TACE联合治疗的病灶,以凝固性坏死、液化性坏死合并存在,表现为局部T1WI呈相对低信号,T2WI呈相对高信号,但动态增强扫描无强化;③8个病灶不完全坏死:在T1WI上呈相对高信号的病灶周边有低信号结节或同时伴新月形低信号带,在T2WI上则表现为等低信号病灶周边出现相对高信号结节或新月形高信号带,在动态增强扫描时呈快进快出强化表现。结论 MRI平扫和动态增强评价微波固化的疗效可靠、准确,微波固化术后定期MRI随访具有重要意义。

Evaluation with MRI on therapeutic effect of percutaneous microwave coagulation therapy for treating liver cancer

Objective To evaluate the effect and the feature of percutaneous microwave coagulation therapy （PMCT） for treating liver cancer with 1.5 T MRI plain scan and dynamic enhanced scan. Methods MRI imaging appearances of 26 ca- ses containing 32 focuses of liver cancer being treated by percutaneous microwave coagulation therapy were analyzed retro- spectively. And the results of alpha-fetoglobulin protein （AFP） and digital subtraction angiography （DSA） were analyzed and compared. Results The MRI imaging appearances at 3 rd day after percutaneous microwave coagulation therapy were high signal on T1 WI and low signal on T2 WI relatively, and low signal on T1 WI and high signal on T2 WI around the focu- ses. The MRI imaging 1 month after being treated showed as follow： （1） 19 focuses only treated by PMCT showed coagu- lation necrosis. The MRI imaging appearances were high signal on T1 WI and low or equal signal on T2WI relatively, and had no enhancement; （2） 5 focuses treated with many intervention therapy methods, especially combining with transcatheter arterial chemoembolization （TACE）, showed both coagulation and liquefaction necrosis coexisting. The MRI imaging appearances were low signal on T1WI and high signal on T2WI relatively, and had not been enhanced; （3） 8 focuses showed necrosis no fully. The MRI imaging displayed low signal scobination or luniForm zone around the high signal focus on T1 WI and high signal scobination or luniform zone around the equal signal focus on T2 WI, and displayed enhancement fast in and out. Conclusion It is reliability and accurate to assess the effect of PMCT for treating liver cancer with MRI plain scan and dynamic enhanced scan. And it is important to follow up regularly with MRI after PMCT.