Yoshioka H, Nakagawa K, Shindou H, Ono Y, Kawakami A, Mabuchi N, Arita S, Fujii K, Yoshida A, Hamada T
Nihon Igaku Hoshasen Gakkai Zasshi. 1989 Feb 25;49(2):119-27.
Transcatheter chemo-embolization (TCE) for hepatocellular carcinoma (HCC) was performed on 31 patients, and on 4 of the 31 patients, it was performed twice. The patients were examined by MR both before TCE and after TCE (1 week and 4-5 weeks respectively). On MR images, the change of the tumor signal intensity was classified into 3 groups. In group 1, (G1, 8 cases), obvious change of intensity was seen in the whole tumor. In group 2, (G2, 10 cases), it was seen in some parts of the tumor and in group 3, (G3, 17 cases), only a very slight change of intensity was seen in the whole tumor. In G1 and G2, the rate of AFP decrease was remarkable, but in G3, it was very slight. In G1 and G2, the change of the tumor signal intensity was divided into 2 types on a T2 weighted image. One, is the increase of the intensity, (6 cases). The other, is decrease of intensity, (12 cases). The former seemed to reflect the intra-tumoral hemorrhage accompanying tumor necrosis, the latter, seemed to reflect the coagulation necrosis. The ring of low and high intensity around the tumor appeared anew in 11 cases, and in 2 cases, it increased in size. These changes which have never been recognized on CT images, were thought to be a granulation tissue around the tumor. The influence of the accumulated lipiodol is slight for the change of intensity on the tumor.
对31例肝细胞癌患者进行了经导管化疗栓塞术（TCE），其中31例中的4例进行了两次该手术。患者在TCE术前和术后（分别为术后1周和4 - 5周）均接受了磁共振成像（MR）检查。在MR图像上，肿瘤信号强度的变化分为3组。第1组（G1，8例），整个肿瘤可见明显的强度变化。第2组（G2，10例），肿瘤部分区域可见强度变化，第3组（G3，17例），整个肿瘤仅见非常轻微的强度变化。在G1和G2组中，甲胎蛋白（AFP）下降率显著，但在G3组中则非常轻微。在G1和G2组中，在T2加权图像上肿瘤信号强度的变化分为2种类型。一种是强度增加（6例），另一种是强度降低（12例）。前者似乎反映了伴随肿瘤坏死的瘤内出血，后者似乎反映了凝固性坏死。11例患者肿瘤周围新出现了低、高强度环，2例患者其大小增加。这些在CT图像上从未见过的变化，被认为是肿瘤周围的肉芽组织。碘油积聚对肿瘤强度变化的影响较小。
