Kim Yeun Jeong, Lee Min Hee, Choi Seo Youn, Yi Boem Ha, Lee Hae Kyung
Department of Radiology, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Gyeonggi-do, Korea.
Medicine (Baltimore). 2019 May;98(19):e15592. doi: 10.1097/MD.0000000000015592.
To identify pretreatment magnetic resonance imaging (MRI) features associated with an incomplete response (IR) to transarterial chemoembolization (TACE) in patients with hepatocellular carcinoma (HCC).The medical records of 89 patients with HCC who had undergone a first TACE were reviewed retrospectively. The size, visual attenuation in the arterial phase, signal intensity (SI) on T1-, T2-, and diffusion-weighted images, and apparent diffusion coefficient (ADC) values of each lesion were evaluated on pretreatment images. The response to TACE was routinely assessed at 4 weeks post-treatment by 4-phase computed tomography. The HCC patients were classified as complete or incomplete responders based on the arterial-phase enhancement of the target lesion.In multivariate analysis, larger lesion diameter (P = .004, OR = 1.06 per millimeter, 95% CI = 1.02-1.11), faint enhancement on arterial phase (P = .021, OR = 3.24, 95% CI = 1.22-9.14), and non-low SI on T1-weighted images (P = .016, OR = 3.36, 95% CI = 1.29-9.32) were significantly associated with increased odds of an IR to TACE in HCC patients.An iso-to-high T1-weighted SI by pretreatment MRI was an independent predictor of an incomplete response to TACE in patients with HCC, in addition to faint arterial enhancement and lesion size.
识别肝细胞癌（HCC）患者经动脉化疗栓塞术（TACE）后不完全缓解（IR）相关的治疗前磁共振成像（MRI）特征。回顾性分析89例行首次TACE的HCC患者的病历。在治疗前图像上评估每个病灶的大小、动脉期视觉衰减、T1加权、T2加权和扩散加权图像上的信号强度（SI）以及表观扩散系数（ADC）值。治疗后4周通过四期计算机断层扫描常规评估对TACE的反应。根据靶病灶的动脉期强化情况将HCC患者分为完全缓解者或不完全缓解者。多因素分析显示，较大的病灶直径（P = 0.004，OR = 每毫米1.06，95%CI = 1.02 - 1.11）、动脉期强化微弱（P = 0.021，OR = 3.24，95%CI = 1.22 - 9.14）以及T1加权图像上非低信号强度（P = 0.016，OR = 3.36，95%CI = 1.29 - 9.32）与HCC患者TACE后IR几率增加显著相关。除了动脉期强化微弱和病灶大小外，治疗前MRI显示等至高T1加权信号强度是HCC患者TACE不完全缓解的独立预测因素。
