The Value Of MRI In Appraising Efficacy Of Transarterial Chemoembolization On HCC

Part1The Application of MRI Scan in Evaluating the Efficacy of TACE and in forcasting before the ProcedureObjective:Investigate the predicting role of MRI in evaluating the therapeutic efficacy and the value of follow-up after transarterial chemoembolization.Method:89cases analyzed Retrospectively, were113lesions’MRI features before and after TACE including the plain scan, dynamic contrast enhanced scan and DWI serials, were studied with the hepatic artery digital subtraction angiography and followed-up. Short-term therapetic efficay of trasarterial chemoembolization were evaluated through the change of MRI contrast enhanced imaging, T1weighted imaging, lesion size, with or without capsule, supplying vasculature, lipiodol deficiency and recurred lesion shape.Result:Lesions with the feature of evident enhancement, high signal in T1WI, low signal in T2WI, size less than5cm, with envelope, simple supplying vasculature, dense lipiodol sedimentation, consistent signal in in-phase and out-phase imaging hold expecting therapeutic efficacy of transarterial chemoembolization.Conclusion:MRI can accurately evaluate the short-term efficacy of transarterial chemoembolization and plays an important role in ptedicting and evaluating post procedure efficacy. Part2Clinical Study of the Application of MRI’s ADC Value in evaluating the Short Term Efficacy of Hepatocellular Carcinoma after TACEObjective:Investigate the clinical value of apparent diffusion coefficient in evaluating the short term therapeutic efficacy of hepatocellular carcinoma after chemoembolization.Method:89cases analyzed Retrospectively, were113lesions’ MRI features including the plain scan, dynamic contrast enhanced scan and DWI serials(b value was0,800s/mm2), compared with the follow-up change and hepatic artery digital subtraction angiography, record and studied the ADC value of viable and necrotic tumor and their DWI feature, appraised their value in and sensitivity in differentiating necrotic and viable tumor.Results:①ADC value of normal liver tissue and viable tumor was (1.34±0.13)×10-3mm2/s and (1.24±0.13)×10-3mm2/s, their diffenrence held evident statistical significance.②ADC value in group A, group B, group C after1month of the procedure were (1.67±0.24)×10-3mm2/s,(1.48±0.14)×10-3mm2/s,(1.21±0.37)×10-3mm2/s. ADC value in group A and group B after the procedure was higher than the value before the procedure. The difference of three groups ADC value hold high statistical significance.③ADC value of1month,3month in group A and group C had no difference. ADC value of3month was lower than1month in group C.4ROC analysis exhibit ADC value of1.54×10-3mm2/s was the threshold in appreciating viable and necrotic tumor. The sensitivity was81.0%, specifity was80.3%.Conclusion:The parameter of ADC value can differentiate viable and necrotic tumor and hold high value in the follow-up of hepatocellular carcinoma after trancarterial chemoembolization. Part3Repeatability and consistency study of magnetic resonance apparent diffusion values of the completely remission lesions of primary liver cancer after TACEObjective:To investigate MR ADC value measurement repeatability and consistency of the primary liver cancer with complete remission lesions after TACE.Methods:The same radiologist measured the ADC values in the same sequence of the complete remission lesions in the first,third,fifth month,and another radiologist repeated the measured again interval of1week. According to calculate the intraclass correlation coefficient (ICC) value and draw Bland-Altman graph to determine the repeatability and consistency of the ADC value measurement.The ICC values is greater than0.75indicates good reliability and high repeatability,75%of the sites were located in the Bland-Altman graph of the95%confidence interval indicates its high consistency within the reference line.Results:The ICC values of A radiologist measured in the first,third,fifth month were0.928,0.878,0.934; The ICC values of B radiologist measured in the first, third,fifth month were0.873,0.940,0.871,the ICC values measurement by A, B radiologist at different times a week before in the first,third,fifth month were0.854,0.940,0.960; he ICC values measurement by A, B radiologist at different times a week later in the first,third,fifth month were:0.788,0.945,0.858, all of them were greater than0.75, suggesting the high credibility and repeatability90%of the sites were located in the Bland-Altman graph of the95%confidence interval indicates its high consistency within the reference line.Conclusion:The stable ADC values which are measured with high repeatability and consistency of complete remission lesions can dynamically observe the degree of stability lesions of primary liver cancer after interventional treatment and help to assess the consolidated treatment timely.