弥散加权成像评估肝癌TACE术后碘油沉积缺损区域的价值

摘要

Objective To analyze the clinically significance of assessing primary liver cancer HCC and poor area of iopiodol deposition after TACE by using the change of ADC values.Method Retrospective analysis on 26 cases of 39 tumor lesions of defect of lipiodol deposition after the treatment of primary liver cancer with TACE.Analyze the characteristics of ADC values in different area before and after operation.The CT enhancement of detect and deposit area of iopiodol after operation will be appraised,as well as the results of DSA subtraction.Result The ADC value of 33 deposit areas of lipiodol is (1.76 ± 0.16) × 10-3 mm2/S,which is significantlylower than that of preoperative tumor tissue (P ＜0.01).The 39 detect areas of iopiodol's ADC value is (0.74 ±0.18) × 10-3 rmm2/S,which has no obvious differences with postoperative tumor tissue.CT enhanced scan in 26 cases of 39 lesions,and 31 lesions of them are enhanced from arterial phase while 3 lesions are enhanced from venous phase,5 lesions have not been enhanced at all.It can be seen obviously that 33 lesions have blood supply in arterial phase of DSA.And the feeding arteries are definite,the boundaries are clear.But there are still 6 lesions that have not seen the arterial blood supply.Conclusion The change characteristics of ADC values will become one kind of reliable imaging markers that can evaluate biological activity of tumor lesions within liver cancer patients who are treated with TACE.%目的 探讨采用ADC值变化评估原发性肝癌HCC TACE术后碘油沉积欠佳区域的的临床意义.方法 回顾性分析TACE治疗富血供原发性肝癌术后碘油沉积缺损病例26例39个瘤灶,分析术前、术后不同区域ADC值特征,并评价术后碘油沉积缺损区域CT增强、以及DSA减影结果.结果 33个碘油沉积区域ADC值为(1.76 ±0.16)×10-3 mm2/S,明显低于术前肿瘤组织(P＜0.01),而术后39个碘油缺损区ADC为(0.74±0.18)×10-3 mm2/S和术前肿瘤组织比较无明显差异(P=0.111).CT增强扫描26例39个缺损灶,其中31个病灶从动脉期强化,3个病灶门静脉期出现强化,5个病灶始终未见强化.在DSA动脉期,可见33个病灶存在明显血供,以及供血动脉明确、边界清晰,6个病灶未见任何动脉血供.结论 ADC值的变化特征能够成为早期评价肝癌患者TACE后瘤灶生物活性的一种可靠影像学指标.