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肝癌介入治疗中磁共振弥散加权成像技术的作用研究

作者:王缉胜1 郭泽波1 黄柳明2

所属单位:1.广西河池第一人民医院放射科(广西 河池 546300) 2.广西南宁市中医院放射科(广西 南宁 530012)

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摘要

目的探讨磁共振弥散加权成像 技术在肝癌介入治疗中的应用价值。方法 以我院放射科收治的32例行介入治疗的肝 癌患者为研究对象,根据其临床资料进行 回顾性分析和总结,分别在其介入治疗 前和介入治疗后7天对其进行常规平扫和 磁共振弥散加权成像扫描,观察患者的影 像学特征,并比较不同扩散敏感梯度值(b 值)下的ADC值。结果 治疗前患者的肿瘤 体积为(204.93±122.89)cm3 ,治疗后下 降到(145.37±117.26)cm3 ,治疗后的肿 瘤体积明显低于治疗前,p<0.05,差异 显著;b值为50、100时其治疗前后的ADC 值没有显著差异,而当b值为300、500、 700时治疗前后的ADC值存在显著差异(p <0.05)。结论 磁共振弥散加权成像技术 在肝癌介入治疗中的应用价值较高,其影 像具有一定的特征性,可以反映肿瘤形态 的微小变化,观察患者介入治疗后肿瘤血 管密度等病理变化情况,对其治疗效果进 行评定,具有较高的临床应用推广价值。

Objective This Paper is to investigate the application value of magnetic resonance diffusion weighted imaging in interventional therapy of liver cancer. Methods Thirty two patients with liver cancer admitted by the Radiology Department of the Hospital undergoing interventional treatment of liver cancer patients were selected as research objects, who were retrospectively analyzed and summarized according to clinical data, those patients underwent routine scanning and magnetic resonance diffusion weighted imaging scanning respectively before interventional treatment and 7 days after interventional treatment, imaging characteristics of patients were observe, and ADC indexes under different diffusion sensitive gradient values (b) were compared. Results The gross tumor volume of patients before treatment 204.93+/-122.89cm3 , and it fell to 145.37+117.26cm2 after treatment, the gross tumor volume of patients after treatment was significantly lower than that of patients before treatment (p<0.05), and differences were significant. There was no significant difference in ADC indexes before and after the treatment when the value of b hit 50 and 100, and there were significant differences in ADC indexes before and after the treatment when the value of b hit 300, 500 and 700 (p <0.05). Conclusions Magnetic resonance diffusion weighted imaging deliver great value in interventional therapy of liver cancer, its images deliver certain characteristics, insignificant changes in the form of tumor may be reflected, and pathological change in tumor vascular density of patients may be observed, and the evaluation on treatment efficacy is of high application and promotion value in clinical practices.

【关键词】肝癌;介入治疗;磁共振弥散加权成像

【中图分类号】R735.7

【文献标识码】A

【DOI】10.3969/j.issn.1672-5131.2015.07.021

前言

肝癌在我国的发病率比较高,由于其临床症状比较隐匿,大多数 患者在发病早期的时候没后比较明显的临床症状,随着时间的推移, 患者病情加重,其症状才会逐渐显现出来,而此时患者已经属于中晚 期,失去了根治性手术的最佳时机[1]。目前,临床上对中晚期肝癌的 治疗方法有很多,介入治疗就是其中一种比较有效的治疗方式,是肝 癌晚期患者的最佳选择,然而对其治疗效果也显得十分重要。随着医 疗水平的发展,磁共振扫描成像技术也在一定程度上有了提高,它可 以通过观察治疗前后病灶的体积、微观结构来评定介入治疗的效果 [2]。因此,近年来,我院以32例行介入治疗的肝癌患者为研究对象, 旨在探讨磁共振弥散加权成像技术在肝癌介入治疗中的应用价值,现 将其报告如下。