论著-头颈部
MRI在评估肝癌介入治疗肝储备功能及预后的临床价值
作者:严德星1 文正青1 刘洪波2 陈智翔3
所属单位:1.广东省韶关市第一人民医院医学 影像科 (广东 韶关 512000) 2.广东省韶关市粤北人民医院肿瘤 放疗科 (广东 韶关 512000) 3.广东省韶关市第一人民医院普外 二科 (广东 韶关 512000)
PDF摘要
目的探讨MRI评估肝癌介入治疗 肝储备功能及预后的临床价值。方法 选 取我院收治的原发性肝癌患者49例,患 者术前均行MRI常规+增强序列扫描,并 统计患者灶周ADC值等。统计介入治疗前 后患者ICGR15、Child-Pugh评分情况。结 果 病灶位于肝左叶22例,肝右叶27例。 介入治疗后3d、5d、7d和14d患者ICGR15 和Child-Pugh评分均低于治疗前,差异 有统计学意义(P<0.05)。患者复发率、 转移率分别为44.90%和48.98%且发生复 发和转移患者的ADC值均低于无复发和转 移患者,ICGR15则高于无复发和转移患者 (P<0.05)。Spearman秩相关分析结果显 示,肝癌介入治疗MRI检测所得灶周ADC值 与其ICGR15、Child-Pugh评分、复发率 和转移率呈负相关(r=-0.763,-0.743,- 0.685,-0.783,P<0.05)。结论 我们发 现原发性肝癌灶周MRI-ADC值越低,患者 灶周肝实质肝硬化/肝纤维化越重,肝癌 复发、转移率就越高,预后就越差。因 此,MRI-ADC值检测结果对肝癌介入治疗 肝储备和预后的评估具有一定的价值。
Objective To explore the value of MRI assessing liver reserve function and prognosis of liver cancer patients treated with interventional treatment. Methods 49 primary liver cancer patients in our hospital were randomly selected. Magnetic resonance imaging (MRI) scan was finished before the treatment and ADC value was statistically analyzed and MRI imaging features of primary liver cancer was observed. ADC value,indocyanine green 15 min retention rate (ICGR15) and Child-Pugh score before and after interventional therapy and patients' prognosis were statistically analyzed. Results the lesions located in the left hepatic lobe of 22 cases, and right liver lobe of 27 cases. Child-Pugh score and ICGR15 of 3d, 5d, 7d and 14d after interventional treatment was lower than that of before treatment, and the difference was statistically significant (P<0.05). Metastasis and recurrence rate of patients were 44.90% and 48.98% respectively. Patients with metastasis and recurrence had lower ADC value and higher Child-Pugh score and ICGR15 than that of Patients without metastasis and recurrence (P<0.05). Spearman relation analysis results showed MRI detected ADC value of patients with primary liver cancer were all negatively connected with hild-Pugh score and ICGR15, recurrence rate and metastasis rate (r=-0.763,-0.743, -0.685, -0.783, P<0.05). Conclusion MRI tested ADC value in patients with primary liver cancer is lower and connected with liver reserve function and prognosis of patients, thus value tested by MRI assessing liver reserve function and prognosis of liver cancer patients treated with interventional treatment is good.
【关键词】MRI;肝癌;介入治疗;肝储备功能;预后
【中图分类号】R735.7
【文献标识码】A
【DOI】 10.3969/j.issn.1672- 5131.2016.04.020
前言
原发性肝癌是常见的恶性肿瘤,其恶性程度高,病情发展迅速, 疗效差,患者生存期短,预后差[1]。原发性肝癌患者确诊时大多数已 属于中晚期,其治疗主要采用介入治疗[2]。介入治疗可在一定程度上 缓解患者临床症状,但亦可造成肝储备功能损伤等的发生[3]。我们前 期研究证实[4-5],灶周的肝硬化CT分级在肝癌介入治疗患者肝储备功能 及预后上具有一定的价值。本研究试图通过分析原发性肝癌患者灶周 的MRI-ADC值,及介入治疗前后肝储备功能的变化,患者预后情况等, 探求MRI检测在患者介入治疗中肝储备功能及预后的价值,现报道如 下。
中国CT和MRI杂志
第14卷, 第 4 期
2016年04月
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