Application Of Diffusion Weighted Magnetic Resonance Imaging In Early Postoperative Curative Effect Evaluation After Radio-frequency Ablation Treatment In Hepatocellular Carcinoma

Objective To study the value of diffusion weighted magnetic resonance imaging(MR- DWI) in early postoperative curative effect evaluation and prognosis after radio-frequency ablation(RFA) treatment in hepatocellular carcinoma(HCC).Methods 98 patients with 119 focuses of HCC in our hospital from the year 2009 to the year 2013 were chosen as study objects, all of whom were treated by CT guided percutaneous RFA. Before and 1~7 days, one month, three months and six months after RFA therapy, the apparent diffusion coefficients(ADC) value were observed by MR- DWI examination and the recurrence focuses were detected by MRI. According to the signal characteristics of tumor nodules and change of ADC values, the presence of tumor recurrence were observed.Results In 119 focuses, when ablated totally, 78 focuses were treated by one time(65.55%), 30 focuses were treated by two times(25.21%), and 33 focuses were treated by three times(9.24%). In 98 patients, 41 patients were occurred complications(41.84%), including 21 cases of hyperpyrexia(21.43%), 17 cases of pain(17.35%), 2 cases of hypertension(2.04%) and one case of pleural effusion(1.02%), all of which were put back after treatment. There was no serious complication occurred such as death, peritoneal cavity bleeding, needle track implantation or neighbour organ injury. There was no recurrence focus in one month after RFA treatment. 6 recurrence focuses were found in three month, and 11 recurrence focuses were found in six months after RFA treatment, with recurrence rates 5.04%(6/119) and 9.24%(11/119), respectively.The ADC value of hepatoma focuses was significantly lower than that of normal liver parenchyma before RFA treatment(P< 0.05), while after RFA treatment, the ADC values were significantly increased(P< 0.05). Hepatoma focuses and normal liver parenchyma had similar ADC value when determined at 1~7 days, one month, three months and six months after RFA treatment(P< 0.05).In recurrent focus, the ADC value had no marked change after RFA treatment compared with that before RFA treatment(P> 0.05), which were much smaller than those of un-recurrent focus at the corresponding time period(P< 0.05). The ADC values of un-recurrent focus were significantly increased after RFA treatment(P< 0.05).Conclusion â‘ CT guided percutaneous puncture RFA for HCC treatment has a recurrence rate less than 10% six months postoperative. It has high safety, without serious complications, and good treatment effect to control tumor progression.â‘¡MR- DWI imaging technique can compare ADC values before and after RFA for dynamically assess curative effect of RFA in HCC patients, which provides the accurate imaging data basis of appropriate treatment pro clinical early. â‘¢ The ADC values in lesions without recurrence in six month after RFA will increase significantly compared with that before RFA, while the ADC values in recurrence lesions in six month after RFA has no obvious change. The ADC values in recurrence lesions are significantly lower than that in lesions without recurrence. This study argues that ADC values can be used as a predictor of recurrence of HCC patients after RFA treatment.