Xiao Yun-Ping, Xiao En-Hua, Luo Jian-Guang, Bian Du-Jun, Li Mo-Qiu, He Zhong, Shang Quan-Liang, Liang Bin
Department of Radiology, The 2nd Xiangya Hospital, Central South University, Changsha 410011, China.
Zhonghua Zhong Liu Za Zhi. 2008 Dec;30(12):914-6.
To explore the pathological basis of diffusion-weighted imaging (DWI) findings in hepatocellular carcinoma (HCC) after transcatheter arterial chemoembolization (TACE).
DWI was performed in 15 patients with HCC treated by TACE within 24 - 48 hours before II-phase operation. The DWI findings of the liver lesions were analyzed and correlated with pathological findings including macroscopic observation, HE staining and immunohistochemical staining for bFGF.
(1) The viable tumor area showed mostly hypersignal intensity (12/15), whereas coagulative necrotic lesions showed hyposignal (8/15) or isosignal intensity (6/15). The ADC values of zones of viable tumor and necrosis in tumor were (1.42 +/- 0.16) x 10(-3) mm(2)/s and (1.58 +/- 0.18) x 10(-3) mm(2)/s, respectively. There was a significant difference of ADC values between the two zones (t = 2.618, P < 0.05). (2) There was a significant difference in ADC values of viable tumor between well and poorly differentiated tumors (t = -2.646, P < 0.05). The distinction of ADC values of the whole tumor was significant among tumors with different degree of necrosis (chi(2) = 7.236, P < 0.05). (3) A negative correlation was observed between bFGF protein expression index and ADC values of viable parts of the tumors in the study group (r = -0.552, P = 0.033).
DWI shows certain characteristic features of the HCC after TACE, and can be used to distinguish viable and necrotic tumor tissues in HCC after TACE.
探讨经动脉化疗栓塞术（TACE）后肝细胞癌（HCC）的扩散加权成像（DWI）表现的病理基础。
对15例接受TACE治疗的HCC患者在二期手术前24 - 48小时内行DWI检查。分析肝脏病变的DWI表现，并与包括大体观察、HE染色及碱性成纤维细胞生长因子（bFGF）免疫组化染色在内的病理结果进行相关性分析。
（1）存活肿瘤区域大多表现为高信号强度（12/15），而凝固性坏死病变表现为低信号（8/15）或等信号强度（6/15）。肿瘤内存活肿瘤区和坏死区的表观扩散系数（ADC）值分别为（1.42±0.16）×10⁻³mm²/s和（1.58±0.18）×10⁻³mm²/s。这两个区域的ADC值有显著差异（t = 2.618，P < 0.05）。（2）高分化和低分化肿瘤的存活肿瘤ADC值有显著差异（t = -2.646，P < 0.05）。不同坏死程度肿瘤的全瘤ADC值差异有统计学意义（χ² = 7.236，P < 0.05）。（3）研究组中bFGF蛋白表达指数与肿瘤存活部分的ADC值呈负相关（r = -0.552，P = 0.033）。
DWI显示了TACE术后HCC的某些特征，可用于区分TACE术后HCC中的存活和坏死肿瘤组织。
