The Study Of IVIM-DWI In The Evaluation Of Curative Effect In HCC After TACE

Objectives:Use IVIM-DWI to measure the diffusion and perfusion parameters of HCC tissues before TACE, necrosis and residual tissues after TACE to explore whether IVIM-DWI can be used to evaluate the curative effects of TACE in the treatment of HCC, and compare the clinic value of IVIM-DWI and DWI to identify residual tissues after TACE.Methods:According to the clinical or pathological diagnosis criteria of HCC,25 cases was selected from June.2014 to December.2015 who were diagnosed as HCC and treated with TACE for the first time in our hospital. All of they accepted MR examination, including T1WI, T2WI, DCE-MRI, DWI, IVIM-DWI, a week ago before TACE and a month after TACE respectively. All the datas were divided into three groups:Group I:HCC tissue before TACE,Group IIA:necrosis tissue after TACE,Group IIB:residual tissue after TACE.Measured the ADC value, D value, D* values and f value of the three groups* and analyzed the statistical significance between group Ⅰ and group ⅡA, group Ⅰ and group ⅡB, group ⅡA and group IIB with corresponding statistical methods. P< 0.05 was considered as statistical differences, P< 0.01 was considered as statistically significant differences. Compared the clinical values of the four parameters in identification for necrotic tissues in HCC after TACE with ROC.Results:The mean ADC value, D value, D value and f value in Group Ⅰ were (1.14±0.14) ×10-3mm2/s, (0.93±0.11) ×10-3mm2/s, (18.03±7.57) ×10-3mm2/s, (27.75±9.23) %; The mean ADC value, D value, D value and f value in Group ⅡA were (1.79±0.36) ×10-3mm2/s, (1.72±0.37) ×10-3mm2/s, (16.10±6.29) ×10-3mm2/s, (20.53±9.39) %; The mean ADC value, D value, D value and f value in Group IIB were (1.20±0.13) ×10-3mm2/s, (1.00±0.13) ×10-3mm2/s, (20.61±6.5) ×10-3mm2/s, (23.12±6.64) %.Statistical analysis showed that between group Ⅰ and group IIA ADC value, D value and f value had statistically significant differences (P< 0.01); between group Ⅰ and group ⅡA D value had statistically differences (P< 0.05);between group ⅡA and group ⅡB there were statistical significant differences (P< 0.01) in ADC value and D value. The ROC showed that ADC value and D value can be used to identify residual tissues, and D value had a larger AUC than ADC value.Conclusions:1. LVTM-DWI and DWI can identify the necrotic tissues and residual tissues in HCC after TACE, and can be used to evaluate the curative effects of TACE in HCC.2. In the evaluation of the curative effects of TACE in HCC, D value had higher clinical value than ADC value.