Department of Radiology, Ege University Faculty of Medicine, 35100 Bornova, Izmir, Turkey.
J Vasc Interv Radiol. 2012 Feb;23(2):241-7. doi: 10.1016/j.jvir.2011.08.030. Epub 2011 Oct 22.
To assess the treatment response of hepatocellular carcinoma (HCC) after transarterial chemoembolization with diffusion-weighted imaging and dynamic contrast-enhanced magnetic resonance (MR) imaging with a 3-T system.
Between February 2010 and November 2010, 74 patients were treated with chemoembolization in our interventional radiology unit. Twenty-two patients (29%) who had liver MR imaging including diffusion and dynamic contrast-enhanced MR imaging on a 3-T system before and after transarterial chemoembolization were evaluated retrospectively. Tumor size, arterial enhancement, venous washout, and apparent diffusion coefficient (ADC) values of lesions, peritumoral parenchyma, normal liver parenchyma, and spleen were recorded before and after treatment. The significance of differences between ADC values of responding and nonresponding lesions was calculated.
The study included 77 HCC lesions (mean diameter, 31.4 mm) in 20 patients. There was no significant reduction in mean tumor diameter after treatment. Reduction in tumor enhancement in the arterial phase was statistically significant (P = .01). Tumor ADC value increased from 1.10 × 10(-3) mm(2)/s to 1.27 × 10(-3) mm(2)/s after treatment (P < .01), whereas the ADC values for liver and spleen remained unchanged. ADC values from cellular parts of the tumor and necrotic areas also increased after treatment. However, pretreatment ADC values were not reliable to identify responding lesions according to the results of receiver operating characteristic analysis.
After transarterial chemoembolization, responding HCC lesions exhibited decreases in arterial enhancement and increases in ADC values in cellular and necrotic areas. Pretreatment ADC values were not predictive of response to chemoembolization.
使用 3T 系统的弥散加权成像和动态对比增强磁共振成像评估经动脉化疗栓塞治疗肝细胞癌（HCC）的疗效。
2010 年 2 月至 2010 年 11 月，在我们的介入放射学单位进行了化疗栓塞治疗的 74 名患者。对 22 名（29%）患者进行了回顾性分析，这些患者在经动脉化疗栓塞前后均进行了包括弥散和动态对比增强磁共振成像的肝脏磁共振成像检查。记录治疗前后病变、肿瘤周围实质、正常肝实质和脾脏的肿瘤大小、动脉增强、静脉洗脱和表观扩散系数（ADC）值。计算了病变 ADC 值与治疗反应之间的差异的显著性。
该研究包括 20 名患者的 77 个 HCC 病变（平均直径 31.4mm）。治疗后肿瘤平均直径无明显缩小。动脉期肿瘤增强减少具有统计学意义（P=0.01）。肿瘤 ADC 值从治疗前的 1.10×10(-3)mm(2)/s 增加到 1.27×10(-3)mm(2)/s（P<0.01），而肝脏和脾脏的 ADC 值保持不变。肿瘤细胞区和坏死区的 ADC 值也在治疗后增加。然而，根据受试者工作特征分析的结果，治疗前的 ADC 值不能可靠地识别反应性病变。
经动脉化疗栓塞后，反应性 HCC 病变表现为动脉增强减少和细胞区及坏死区 ADC 值增加。治疗前的 ADC 值不能预测化疗栓塞的反应。
