MRI对原发性肝细胞癌TACE术疗效评价及其复发的预测价值

目的探讨MRI对原发性肝细胞癌(HCC)经导管肝动脉灌注化疗及栓塞术(TACE术)疗效评价及其复发的预测价值。方法回顾性分析2016年1月-2017年6月收治的65例行TACE术治疗的HCC患者临床资料,患者术前1-2天、术后一个月均行MRI、数字减影血管造影技术(DSA)检查,评估MRI对HCC患者TACE术疗效评价及术后复发的预测价值。结果以DSA检查结果为金标准,MRI诊断HCC患者TACE术后残余病灶的灵敏度为91.07%、特异度为69.23%、准确度为84.15%;MRI检查HCC患者TACE术后不同类型碘油沉积共有9例患者碘油沉积复发类型不一致,MRI诊断不同类型碘油沉积复发与DSA诊断的一致性为89.02%(73/82),碘油沉积区ADC值较术前瘤区、肿瘤复发区明显大,术前瘤区ADC值也明显大于肿瘤复发区,差异显著(P<0.05)。结论 MRI在HCC患者TACE术治疗中,可准确地分析术后碘油沉积情况和病灶残留情况,对TACE术疗效评价及其复发预测有明确价值。

Curative Effect Evaluation on TACE for Primary Hepatocellular Carcinoma and its Predictive Value of Recurrence by MRI

Objective To investigate the curative effect evaluation on transcatheter hepatic artery infusion chemotherapy and embolization(TACE) for primary hepatocellular carcinoma(HCC) and its predictive value of recurrence by MRI. Methods A retrospective analysis was performed on the clinical data of 65 patients with HCC undergoing TACE in the hospital from January 2016 to June 2017. MRI and digital subtraction angiography(DSA) were performed at 1-2 days before and 1 month after surgery. Curative effect on patients with HCC after TACE and the predictive value of postoperative recurrence by MRI were evaluated. Results Taking DSA results as the golden standard, the sensitivity, specificity and accuracy of MRI for the diagnosis of residual lesions in patients with HCC undergoing TACE were 91.07%, 69.23% and 84.15%, respectively. There were 9 cases with inconsistent recurrence types of lipiodol deposition in the examination for patients with HCC after TACE by MRI. The consistency of MRI and DSA for the diagnosis of recurrence types of lipiodol deposition was 89.02%(73/82). The ADC value of lipiodol deposition area was significantly larger than that of preoperative tumor area and tumor recurrence area. The ADC value of the preoperative tumor area was also significantly larger than that of the tumor recurrence area(P<0.05). Conclusion MRI can accurately analyze postoperative lipiodol deposition and residual disease in patients with HCC during TACE. It has clear value for curative effect evaluation of TACE and recurrence prediction.