Application Of MR Multi-parameter Imaging In The Evaluation Of Hepatocellular Carcinoma After Transcatheter Arterial Chemoembolization Treatment

Objective:Using dynamic enhanced MRI(DCE-MRI)imaging to explore the quantitative evaluation indexes and application value of residual active tumors/relapsed lesions in patients with HCC after TACE treatment,so as to provide quantitative basis for distinguishing tumor residual/recurrence.Materials and Methods:A total of 30 cases of hepatocellular carcinoma were included and reviewed for MR after TACE in our hospital.There were 26 males and 4 females,with an average of 54± 10 years old.All patients underwent DCE-MRI scan on Siemens 1.5T magnetic resonance,and underwent DSA examination within 2 weeks.With the reference of DSA image,DCE-MRI images were post-processed by the Omni-Kinetic software to measure the DEC-MRI parameters(Ktrans,Kep,Ve,TTP,Max Conc,Max Slope)of the tumor active area,adjacent normal liver parenchyma and tumor necrosis area,and the pseudo color map of the corresponding parameters were obtained.Kruskal-Wallis H test was used to compare the differences between the above six parameter values in the tumor active area,adjacent normal liver parenchyma and tumor necrosis area.The differential diagnosis efficiency of the six parameters for tumor,normal liver and necrotic tissue was evaluated by ROC curves.P<0.05 was considered statistically significantResults:There were 40 tumor lesions in 30 patients.(1)We compared the DCE-MRI parameter values of the tumor active area,tumor necrosis area and adjacent normal liver tissues.The results showed that the differences between any two of the three tissues of Ktrans,TTP,Max Conc and Max Slope had a significant significance(P<0.05);Kep had significant difference between tumor and normal liver,tumor and necrosis area(P<0.05);(2)We evaluated the diagnostic efficacy of DCE-MRI parameters in identifying tumor activity areas,normal liver and tumor necrosis areas.The results showed:① Kep,Ktrans,Max Slope,and Max Conc were effective in identifying tumor active areas and adj acent normal liver tissues.The AUCs were 0.945,0.899,0.832,and 0.782.Among which Kep was the best,it had high sensitivity and specificity(82.50%,95.92%respectively);②Ktrans,Kep,TTP,Max Conc were more effective in identifying tumor active area and tumor necrosis area,the AUCs of them were 0.978,0.926,0.973,0.911 respectively.Among them Ktrans had the best differential diagnosis efficiency and the highest sensitivity and specificity(97.50%and 93.33%,respectively).Conclusion:DCE-MRI parameters can be used to identify different tissue components in liver after TACE.It can detect residual active tumor/recurrent lesions in the early stage,especially Ktrans and kep,which will support the evaluation of active lesions after TACE and guide further treatment plan.Objective:Intravoxel incoherent motion diffusion weighted imaging was used to analyze the quantitative evaluation indexes and application value of residual active tumor/relapse lesions in HCC patients after TACE treatment,so as to provide a quantitative basis for identifying tumor residual/relapse.Materials and methods:50 cases of hepatocellular carcinoma were included and reviewed for MR after TACE treatment in our hospital.There were 41 males and 9 females,with an average of 55 ±10 years old.All patients were scanned on Siemens 1.5T magnetic resonance using IVIM-DWI sequence(a total of 12 b values were selected),and examined by DSA within 2 weeks.MITK-Diffusion software was used to post-process the IVIM-DWI image,the IVIM-DWI parameter values of the tumor active area,adjacent normal liver parenchyma and tumor necrosis area,including f,D,D*values.The Kruskal-Wallis H test was used to compare the differences in f,D,and D*values between the tumor active area,adjacent normal liver parenchyma and tumor necrosis area.Analyzing f.D,D*value of tumor,normal liver and necrotic tissue differential diagnosis efficiency through the ROC curve.P<0.05 was considered statistically significant.Results:There were 67 tumor lesions in 50 patients.(1)We compared the IVIM-DWI parameter values of the tumor active area,adjacent normal liver tissue and tumor necrosis area.The results showed that there were significant differences in f and D values between any two of the tumor active area,adjacent normal liver parenchyma and tumor necrosis area(P<0.05).The D*value was significantly different between the tumor active area and the necrotic area,also between the normal liver parenchyma and the tumor necrotic area(P<0.05).(2)We evaluated the diagnostic efficacy of IVIM-DWI parameters for identifying tumor active area,normal liver and tumor necrosis area.The results identified that f value and D value were most effective in identifying tumor active area and necrotic tissue,The AUCs of those were 0.959 and 0.955 respectively.f value and D value were more effective in identifying the tumor active area and adjacent normal liver tissue,and the AUC of those were0.842 and 0.795,respectively.Conclusion:The IVIM-DWI parameters identify different tissue components in liver after TACE without use of contrast agents.It can also detect residual active tumor/recurrent lesions in the early stage,especially with f and D value,which support the evaluation of active lesions after TACE and guide further treatment plan.