目的 探讨扩散加权成像(DWI)联 合CT增强扫描对动脉化疗栓塞术(TACE) 治疗肝癌患者疗效评估的临床价值。方 法 以我院2012年1月-2015年1月收治的40 例肝癌患者为研究对象，均行TACE治疗， 术后4-6周行DWI检查及CT增强扫描，以术 后再次数字血管减影造影(DSA)肿瘤染色 结果为标准，分析DWI、CT增强扫描及两 者联合对患者术后肿瘤残留或复发评估敏 感度、特异度及准确度。结果 TACE术后 MRI或CT复查发现病灶95个，DSA证实病灶 阳性77个，阴性18个。以DSA结果为金标 准，DWI联合CT增强扫描敏感度100.0%， 特异度94.4%，准确度98.9%，CT增强扫描 敏感度、特异度、准确度分别为84.4%、 88.9%、85.3%。结论 DWI联合CT增强扫描 对TACE术后病灶残留或复发检出率比DWI 或CT增强扫描高，可作为肝癌患者TACE治 疗效果评估的主要手段。

Objective To investigate the clinical value of diffusion weighted imaging (DWI) combined with CT enhanced scan in the evaluation of the curative effect of transcatheter arterial chemoembolization (TACE) in the treatment of patients with liver cancer. Methods 40 patients with liver cancer treated in our hospital from January 2012 to January2015 were taken as the research objects and were treated with TACE. In postoperative 4 to 6 weeks, DWI and CT enhanced scan were performed. The results of postoperative digital subtraction angiography (DSA) tumor staining again were taken as the golden standard to analyze the sensitivity, specificity and accuracy of DWI and CT enhanced scan and the combination of the two in the evaluation of tumor residual or recurrence. Results After TACE, 95 lesions were found by MRI or CT reexamination, 77 positive lesions were confirmed by DSA and 18 lesions were negative. Taking the results of DSA were taken as the golden standard, the sensitivity of DWI combined with CT enhanced scan was 100.0%, specificity 94.4% and accuracy 98.9%. The sensitivity, specificity and accuracy of CT enhanced scan were 84.4%, 88.9% and 85.3%, respectively. Conclusion The detection rate of DWI combined with CT enhanced scan in tumor residue or recurrence after TACE was higher than that of DWI or CT enhanced scan, which can be used as a major method in the evaluation of the curative effect of TACE in the treatment of patients with liver cancer