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体素内不相干运动弥散加权磁共振成像在兔肝 VX2 肿瘤射频消融早期疗效评估中的应用。

Intravoxel Incoherent Motion Diffusion-weighted MR Imaging for Early Evaluation of the Effect of Radiofrequency Ablation in Rabbit Liver VX2 Tumors.

机构信息

Department of Radiology, Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine, Guangzhou 510060, China.

Department of Interventional Radiology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China.

出版信息

Acad Radiol. 2018 Sep;25(9):1128-1135. doi: 10.1016/j.acra.2018.01.010. Epub 2018 Mar 1.

Abstract

RATIONALE AND OBJECTIVES

This study aims to investigate the value of intravoxel incoherent motion (IVIM)-derived parameters for early evaluation of the efficiency of radiofrequency ablation (RFA) treatment for rabbit liver VX2 tumor.

MATERIALS AND METHODS

Eighteen rabbit liver VX2 tumor models were constructed, and computed tomography-guided RFA was performed. One day before and 7 days after RFA, 18 models underwent magnetic resonance imaging, including contrast-enhanced imaging and IVIM diffusion-weighted imaging with 16 b-factors (0-1000 s/mm). Post-RFA liver tumors were segmented into viable tumor, inflammatory reaction, and ablation necrotic regions according to gross and histopathologic examinations. Parameters derived from IVIM were calculated. One-way analysis of variance and least significant difference test were used for comparisons among the three regions. The diagnostic performance of parameters was evaluated using receiver operating characteristic (ROC) analysis.

RESULTS

ADC, D, and f values were significantly lower in viable tumor than in inflammatory reaction regions (all P < .05), but D* showed no significant difference between the two regions. ADC values of viable tumor regions were significantly lower than that of ablation necrotic regions (P = .007), but D* values of necrotic regions were significantly lower than that of viable tumor regions (P = .045). In ROC analysis, ADC showed the highest area under the ROC curve for differentiating inflammatory reaction from viable tumor region.

CONCLUSIONS

ADC, D, and f were valuable discriminating markers for differentiation between regions of viable tumor and inflammatory reaction in post-RFA tumor, especially ADC outperformed the other two parameters with higher diagnostic performance.

摘要

背景与目的

本研究旨在探讨体素内不相干运动(IVIM)衍生参数在评估兔肝 VX2 肿瘤射频消融(RFA)治疗早期疗效中的价值。

材料与方法

构建 18 只兔肝 VX2 肿瘤模型,行 CT 引导下 RFA。RFA 前 1 天及后 7 天,18 只模型进行磁共振成像,包括对比增强成像和 IVIM 扩散加权成像,b 值为 16(0-1000 s/mm)。根据大体和组织病理学检查,将 RFA 后肝肿瘤分为存活肿瘤、炎症反应和消融坏死区。计算 IVIM 衍生参数。采用单因素方差分析和最小显著差异检验对三组区域进行比较。采用受试者工作特征(ROC)曲线分析评估参数的诊断性能。

结果

存活肿瘤区 ADC、D 和 f 值明显低于炎症反应区(均 P<0.05),但 D值在两个区域间无显著差异。存活肿瘤区 ADC 值明显低于消融坏死区(P=0.007),但坏死区 D值明显低于存活肿瘤区(P=0.045)。在 ROC 分析中,ADC 区分炎症反应与存活肿瘤区的 ROC 曲线下面积最高。

结论

ADC、D 和 f 是区分 RFA 后肿瘤存活肿瘤区和炎症反应区的有价值的鉴别标志物,特别是 ADC 具有较高的诊断性能,优于其他两个参数。

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