[The quantitative analysis of MR dynamic contrast-enhangced imaging on efficacy and prognosis of transcatheter arterial chemoembolization on hepatocellular carcinoma].

Objective: To investigate the prognostic value of quantitative parameters of dynamic contrast-enhangced MR (DCE-MR) on short-term efficacy of transcatheter arterial chemoembolization (TACE) on hepatocellular carcinoma(HCC). Methods: 79 patients with HCC underwent non-enhanced MR imaging and DCE on a 3.0T MR scanner before and one month after TACE. The quantitative parameters were measured on the maximal tumor region, including maximal tumor diameter(MTD), ADC, K(trans,) K(ep) and V(e) value before and after TACE. All patients were divided into stable group (36 patients) and progressive group (43 patients) based on follow-up. The quantitative data of the two groups before and after TACE was collected for analysis. Results: Among the 79 lesions in 79 patients, 21 were located in the left lobe of the liver, 53 in the right lobe of the liver and 5 in the junction area of the hepatic lobe. The maximum tumor diameter (MTD) was 2.2-9.9 cm, the median MTD was 5.1 cm. There were significant differences between progressive group and the stable group in MTD, K(trans,) K(ep) values of the tumor before TACE (P<0.05). One month after TACE, the MTD, K(trans,) K(ep,)ΔMTD, ΔK(trans) and ΔK(ep) values of the tumor in progressive group were statistically different with the stable group (P<0.05, respectively). For all the patients, the pre-TACE MTD, AFP, K(trans) and K(ep) values of tumors were statistically different with the post-TACE values (P<0.05). Conclusion: The quantitative parameters (K(trans,) K(ep,)ΔK(trans) and ΔK(ep) values) of the DCE-MR could predict and evaluate the short-term efficacy of TACE on HCC.目的： 探讨磁共振动态增强(DCE)定量指标在肝细胞癌经导管肝动脉化疗栓塞(TACE)治疗短期疗效预测和评估中的价值。 方法： 选取单病灶肝细胞癌患者79例，在1次TACE治疗前后，全部患者均行MR常规和DCE序列扫描，分别检测肿瘤最大层面的定量指标，包括血管通透性常数(K(trans))、血管外细胞外间隙容积百分比(V(e))及血液回流常数(K(ep))。根据随访，将肝癌患者分为疾病稳定组(36例)和疾病进展组(43例)，比较两组患者在1次TACE治疗前后各定量指标的差异。 结果： 79例患者中，肿瘤位于肝左叶21例，肝右叶53例，肝左右叶交界区5例；肿瘤最大径(MTD)为2.2～9.9 cm，中位MTD为5.1 cm。在TACE治疗前，疾病稳定组和疾病进展组患者的MTD、K(trans)和K(ep)值比较，差异有统计学意义(均P<0.05)。疾病稳定组和疾病进展组患者1次TACE治疗后的MTD、K(trans)、K(ep)及1次TACE治疗前后相关参数的变化值ΔMTD、ΔK(trans)和ΔK(ep)的比较，差异均有统计学意义(均P<0.05)。同一患者1次TACE治疗前后的MTD、甲胎蛋白、K(trans)和K(ep)值比较，差异有统计学意义(均P<0.05)。 结论： DCE的定量指标K(trans)和K(ep)值及其1次TACE治疗前后的变化值可以预测和评估肝细胞癌TACE治疗的短期疗效。.