经导管肝动脉化疗栓塞术前后肝细胞癌的磁共振成像

MRI of hepatocellular carcinoma before and after transcatheter chemoembolization.

作者信息

De Santis M, Torricelli P, Cristani A, Cioni G, Montanari N, Sardini C, Ventura E, Romagnoli R

机构信息

Institute of Radiology, University of Modena, Italy.

出版信息

J Comput Assist Tomogr. 1993 Nov-Dec;17(6):901-8. doi: 10.1097/00004728-199311000-00010.

DOI:10.1097/00004728-199311000-00010

PMID:8227575

Abstract

OBJECTIVE

Magnetic resonance imaging of hepatocellular carcinomas (HCCs) was performed before and after transcatheter arterial chemoembolization (TACE). The changes of tumor signal intensity were compared to residual tumor or tumor recurrence in the follow-up period.

MATERIALS AND METHODS

Fifteen cirrhotic patients with HCC were studied. All patients were examined with MRI both before and 3 months after TACE. Requirement for the study was that all lesions were detectable by MR before TACE.

RESULTS

Magnetic resonance imaging detected 31 tumors. The changes of tumor signal intensity were compared to residual tumor or tumor recurrence in the follow-up period. On T1-weighted (T1W) images before TACE, 16 tumors were hyperintense, 11 were isointense, and 4 were hypointense; on T2W images, 26 tumors were hyperintense, 5 were isointense, and none were hypointense. On T1W images 3 months after TACE, 8 tumors were hyperintense, 18 were isointense, and 9 were hypointense; on T2W images, 11 were hyperintense, 11 were isointense, and 9 were hypointense. All the tumors that became hypointense on T2W images after TACE did not recur on follow-up. All lesions that were still hyperintense on T2W images after TACE showed residual tumor during the follow-up. Among 11 tumors that were isointense on T2W images after TACE, 7 were hyperintense on T2W images before TACE; 6 of these did not recur. Four tumors were isointense on T2W images before and after TACE; 2 of these showed residual tumor in the follow-up. On T2W images after TACE, 15 of 16 HCCs that decreased in signal intensity did not recur on follow-up. On T1W images no correlation was seen between the changes of the signal intensity of the lesion and tumor recurrence in the follow-up; however, 9 of 17 HCCs that did not recur after TACE showed decreased signal intensity. All the tumors (10 of 10) with decreased signal intensity on both T1W and T2W images after TACE did not show tumor recurrence on follow-up.

CONCLUSION

The results suggest that MRI is useful in the assessment of the therapeutic effect of TACE in HCC.

摘要

目的

在经动脉化疗栓塞术（TACE）前后对肝细胞癌（HCC）进行磁共振成像检查。将肿瘤信号强度的变化与随访期内的残留肿瘤或肿瘤复发情况进行比较。

材料与方法

对15例肝硬化合并HCC患者进行研究。所有患者在TACE术前及术后3个月均接受MRI检查。本研究的要求是所有病变在TACE术前均能被MR检测到。

结果

磁共振成像检测到31个肿瘤。将肿瘤信号强度的变化与随访期内的残留肿瘤或肿瘤复发情况进行比较。在TACE术前的T1加权（T1W）图像上，16个肿瘤呈高信号，11个呈等信号，4个呈低信号；在T2W图像上，26个肿瘤呈高信号，5个呈等信号，无低信号。在TACE术后3个月的T1W图像上，8个肿瘤呈高信号，18个呈等信号，9个呈低信号；在T2W图像上，11个呈高信号，11个呈等信号，9个呈低信号。所有在TACE术后T2W图像上变为低信号的肿瘤在随访中均未复发。所有在TACE术后T2W图像上仍呈高信号的病变在随访中均显示有残留肿瘤。在TACE术后T2W图像上呈等信号的11个肿瘤中，7个在TACE术前T2W图像上呈高信号；其中6个未复发。4个肿瘤在TACE术前及术后T2W图像上均呈等信号；其中2个在随访中显示有残留肿瘤。在TACE术后T2W图像上，16个信号强度降低的HCC中有15个在随访中未复发。在T1W图像上，病变信号强度的变化与随访期内的肿瘤复发之间未见相关性；然而，17个在TACE术后未复发的HCC中有9个信号强度降低。所有在TACE术后T1W和T2W图像上信号强度均降低的肿瘤（10个中的10个）在随访中均未显示肿瘤复发。