磁共振DWI技术结合ADC值量化分析在原发性肝癌的随访价值

目的分析患者肝癌肿瘤组织的表观扩散系数(ADC)值,评估磁共振扩散加权成像(DWI)技术评估肝癌的临床治疗疗效及预后的能力。方法对53例肝癌患者行磁共振扩散加权成像(DWI)、T1WI、T2WI和T1WI钆对比剂增强扫描,分析观察肝癌存活的肿瘤组织与肿瘤液化坏死组织成分的DWI与增强图像上的信号特征,测量并计算病灶的ADC值与对应的磁共振T1WI增强扫描最大强化值,进行统计学分析。结果磁共振DWI成像上肝癌肿瘤组织表现为稍高于周围肝实质的高信号,钆增强扫描显示明显强化;液化坏死部分表现为明亮高信号,增强后无明显强化;ADC图上肿瘤组织为稍高于正常肝实质的高信号,肿瘤坏死组织部分为低信号;b=800s/mm2时均数ADC值(mm2/s)是:肝癌肿瘤组织约为(1.02±0.37)×10-3,肿瘤坏死组织约为(1.71±0.32)×10-3,正常肝实质约为(1.29±0.42)×10-3。磁共振T1WI增强扫描上肝癌肿瘤组织表现为明显强化,其内液化坏死组织未见明显强化,肝癌组织的ADC值与T1WI增强扫描最大强化值之间呈负性相关关系(P<0.01)。结论综合分析肝癌组织成分的平均ADC值,发现磁共振扩散加权成像扫描技术能更好地显示出肝癌经过临床治疗后的肿瘤残留或复发组织与坏死液化组织成分,表观扩散系数(ADC)值能够反映出经过临床抗肿瘤治疗后肝癌的肿瘤残余或复发组织的血供情况以及细胞的活性。由此可见,磁共振扩散成像技术结合ADC值可以作为肝癌的临床抗肿瘤治疗疗效及预后随访手段。

Quantitative study in apparent diffusion coefficients evaluate the diffusion-weighted MR imaging for clinical follow-up of liver cancer

Objective To investigate prospectively the capability of diffusion-weighted imaging(DWI) for assessing the effects of tumor therapy in liver cancer by the apparent diffusion coefficient(ADC).Methods Diffusion-weighted imaging and Dynamical Contrast enhancement MRI were performed in 53 consecutive patients with liver cancer.To analyze MRI findings of lesions.Signal intensities on the DW images and apparent diffusion coefficient(ADC) maps were noted.ADCs and maximum MR T1-weighted image(T1WI) enhancement value in all lesions were measured and calculated with Student’s t test and Pearson correlations.Results The majority of liver cancer lesions showed hyperintensity on DW images and hypointensity on ADC maps.The mean ADCs(mm2/s) were(1.02±0.37)×10-3in lesions,(1.71±0.32)×10-3 in necrosis,(1.29±0.42)×10-3in the normal liver parenchyma by b=800s/mm2.On post contrast images there is homogeneous enhancement,except for a focal area of hypointensity,possibly an area of necrosis.The ADCs is obviously negative to the maximum MR T1-weighted imaging(T1WI) enhancement value of liver cancer(P<0.01).Conclusion DW MR imaging,with the help of quantitative study in liver cancer using ADC value,Would improve the accuracy in detecting tumor remnant or recurrence of liver cancer.It’s an useful method for the follow-up.