| Object: To analyze diffusion and perfusion information with using MR introvoxel incoherent motion(IVIM)model to explore the application value of early curative effect evaluation of transcatheter arterial chemoembolization in hepatocellular carcinoma.Methods: 1. Sixteen cases were collected from December 2014 to December 2015 in our hospital which diagnosed hepatocellular carcinoma, Including 11 male cases and 5 female cases. The age of scope were 29~73, the median age 52. A total of 16 patients with HCC underwent concentional Magnetic Resonance Imaging and Multi-b value Diffusion Weighted Imaging scans in 1 ~ 3 days before TACE and 7 ~ 10 days after TACE. 2. Using GE Discovery 750 3.0T MR and 8-channel phased body coil. 3. With Functool software in the AW4.6 workstation, combine conventinal Magnetic Resonance Imaging to selecte the region of interest(ROI),and the ROI of tumor section should include all lesion area.The non-tumor section when selecting ROI should try to avoid the blood vessel, biliary tract and artifacts.the apparent diffusion coefficient(Stand ADC value), slow apparent diffusion coefficient(D value),fast apparent diffusion coefficient(D* value) and fraction of fast ADC(f value) before and after TACE were acquired and compared. Each parameter value measurement method is the same,the choice of ROI in the same location, size and pixel before and after TACE. 4. If conforming with normal distribution, to use the paired samples t-test, Otherwise, using the matching samples to compare Wilcoxon signed rank and inspection. Take α=0.05 for inspection level, statistical analysis with P<0.05 for the difference was statistically significant.Results: 1. A total of 16 cases of HCC patients was 16 lesions, 13 cases of which located in the right hepatic lobe, 3 cases in the left hepatic lobe. The maximal tumor diameter is 2.4cm ~9.2 cm, the median 4.5 cm. 2. The value of apparent diffusion coefficient(Stand ADC value)of before and after TACE in tumor section were(0.97±0.10)×10-3mm2/s,(1.21±0.06)×10-3mm2/s; the value of slow apparent diffusion coefficient(D value) were(0.83±0.11)×10-3mm2/s,(1.00±0.13)×10-3mm2/s; the value of fast apparent diffusion coefficient(D*value) were(34.90±8.66)×10-3mm2/s,(27.69±5.86)×10-3mm2/s, the value of fraction of fast ADC(f value)were(27.18±6.86)%,(19.27±5.07)%, and t-value was respectively 20.761,17.597,﹣6.832,﹣10.718. The differences were statistically significant(P < 0.05). 3. The value of apparent diffusion coefficient(Stand ADC value) of before and after TACE in non-tumor section were(1.25±0.13)×10-3mm2/s,(1.28±0.14)×10-3mm2/s; the value of slow apparent diffusion coefficient(D value) were(1.03±0.14)×10-3mm2/s,(1.07±0.17)×10-3mm2/s; the value of fast apparent diffusion coefficient(D*value) were(60.21±11.65)×10-3mm2/s,(62.34±13.77)×10-3mm2/s, the value of fraction of fast ADC(f value) were(32.50±5.41)%,(33.16±6.15)%, and statistic is respectively 2.090,﹣1.838,1.919,﹣0.310. There were no differences(P>0.05). 4. The Stand ADC values,D value,D*and f values of the tumor section compared with the non-tumor section before and after TACE,significant statistical difference were existed(P<0.05).Conclusion: 1. MR IVIM imaging can sensitively monitor early changes of HCC after TACE and quantitative analysis of lesions.Important referent value for evaluate efficacy of TACE. 2.MR IVIM imaging has the advantages of without injection of contrast materialstrong,repeatability and safe noninvasive, especially for renal insufficiency also checking, and reflecting the organization before earlier than changes in tumor size microcirculation status,personalized treatment options for patients and follow-up imaging supporting the improvement of the treatment plan. |
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