Zhang Guangyuan, Li Wentao, Wang Guangzhi, He Xinhong, Xu Lichao, Wang Shengping, Peng Weijun
Department of Radiology, Shanghai Proton and Heavy Ion Center.
Department of Radiology.
Medicine (Baltimore). 2020 Jun 26;99(26):e20795. doi: 10.1097/MD.0000000000020795.
To explore different posttreatment changes between multimode tumor ablation therapy (MTAT) and radiofrequency ablation (RFA) using intravoxel incoherent motion diffusion-weighted imaging (IVIM-DWI) and diffusion kurtosis imaging (DKI) in patients with hepatic malignancies.Eighty - seven patients with one hundred and twenty eight hepatic lesions receiving MTAT or RFA underwent IVIM-DWI and DKI before and after treatment. The mean value of apparent diffusion coefficient (ADC), IVIM-DWI parameters, including true diffusion coefficient (D), pseudo-diffusion coefficient (DP), perfusion fraction (f), and DKI parameters including diffusion coefficient (DK), apparent diffusional kurtosis (K) were retrospectively compared prior to and following treatment as well as between treatment groups. The degree of parameters change after ablation was compared between 2 treatment modalities.The mean value of ADC, D, and DK increased while f, and K decreased significantly in MTAT group. In RFA group, just ADC and K showed significantly change following treatment. The ADC and D value were higher in MTAT group than in RFA group 1 month after treatment. While f was lower in MTAT group after treatment compared with RFA group. The ADC, D and DK increased (21.89 ± 24.95% versus 8.76 ± 19.72%, P = .04 for ADC, 33.78 ± 54.01% versus 7.91 ± 25.16%, P = .03 for D, 25.91 ± 36.28% versus 1.75 ± 46.42%, P = .01 for DK) while f declined (-32.62 ± 41.48% versus 6.51 ± 44.16%, P < .001) more in MTAT group.The MTAT induced different posttreatment changes on water molecule diffusion and microvasculature related functional MR parameters compared to RFA in patients with liver tumors.
利用体素内不相干运动扩散加权成像(IVIM-DWI)和扩散峰度成像(DKI),探讨多模式肿瘤消融治疗(MTAT)与射频消融(RFA)治疗肝恶性肿瘤患者后不同的变化情况。87例患有128个肝脏病灶的患者接受了MTAT或RFA治疗,并在治疗前后进行了IVIM-DWI和DKI检查。回顾性比较治疗前后以及治疗组之间表观扩散系数(ADC)、IVIM-DWI参数(包括真实扩散系数(D)、伪扩散系数(DP)、灌注分数(f))和DKI参数(包括扩散系数(DK)、表观扩散峰度(K))的平均值。比较两种治疗方式消融后参数变化的程度。MTAT组中,ADC、D和DK的平均值升高,而f和K显著降低。在RFA组中,仅治疗后ADC和K有显著变化。治疗1个月后,MTAT组的ADC和D值高于RFA组。而MTAT组治疗后的f低于RFA组。MTAT组中ADC、D和DK升高(ADC为21.89±24.95%对8.76±19.72%,P = 0.04;D为33.78±54.01%对7.91±25.16%,P = 0.03;DK为25.91±36.28%对1.75±46.42%,P = 0.01),而f下降幅度更大(-32.62±41.48%对6.51±44.16%,P < 0.001)。与RFA相比,MTAT在肝肿瘤患者中诱导了与水分子扩散和微血管相关的功能磁共振参数不同的治疗后变化。