目的：探讨表观扩散系数（ADC）评价经导管肝动脉化疗栓塞（TACE）治疗肝细胞癌（HCC）疗效的运用价值。方法：以86例 HCC患者行TACE治疗的110个病灶为对象。根据疗效，将病灶分为优良组（20个）、一般组（62个）和差组（28个）。在治疗前和治疗3个月后，对89例正常肝组织和110个病灶行M RI ，比较正常肝组织和肿瘤组织、各组病灶和肿瘤活性组织与坏死组织的ADC值，并进行ROC分析。结果：肿瘤组织治疗前和治疗后的ADC值与正常组织比较有统计学差异（t＝3．164、3．087，P＜0．05）。治疗3个月后，优良组ADC值为（1．65 ± 0．17）×10－3 mm2／s ，显著高于其他组（P＜0．05）。肿瘤活性组织ADC值为（1．26±0．15）×10－3 mm2／s ，坏死组织 ADC值为（1．66±0.23）×10－3 mm2／s。取1．54×10－3 mm2／s为阈值，坏死组织诊断敏感度为82．4％，特异度为81．5％。ROC曲线下面积为0．884。结论：ADC值可以作为 HCC患者TACE术后疗效判断的参考指标。%Objective :To investigate the value of ADC for evaluating the recent curative effect of TACE on patients with HCC .Methods :86 cases of HCC patients accompanied 110 lesions treated with TACE were taken as object .Ac‐cording to the curative effect ,participants were divided into excellent group (20) ,the general group (62) and poor group (28) .The ADC of normal liver tissues and tumor tissues ,the general group ,the poor group and the excellent group ,the necrotic tissue and the tumor active tissue were compared after treated by 3 months .And the ROC analysis was valued .Results:the ADC of tumor tissues before treated and treated after 3 months were significant difference compared with normal tissue (t=3 .164 ,3 .087 ,P<0 .05) .The ADC of excellent group after treated 3 months was (1.65 ± 0 .17)× 10-3mm2/s ,which was significant higher compared with other groups(P<0 .05) .The ADC of activi‐ty tumor tissue was (1 .26 ± 0 .15) × 10-3 mm2/s ,which was significant lower than the necrotic tissue with (1 .66 ± 0.23) × 10-3 mm2/s .Taken 1 .54 × 10-3 mm2/s for the threshold ,the diagnostic sensitivity of necrotic tissue was 82.4% ,specificity was 81 .5% .The area under the ROC curve was 0 .884 .Conclusion:ADC could be used as a reference index for curative effect judgment of HCC patients treated with TACE .
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