The Value Of IVIM In Evaluating The Efficacy Of TACE Sequential Argon-helium Cryoablation For Liver Cancer

Objective:(1) To explore the evaluation value of Intravoxel incoherent motion (IVIM) double exponential model with Many of the b values scanning technology, which is used to evaluate the curative effect of hepatocellular cancer after treatment of TACE combined with argon-helium knife cryotherapy.(2) To compare the evaluation value Of hepatocellular cancer activity after treatment of TACE combined with argon-helium knife cryotherapy by double exponential model DWI imaging and single index model DWI imaging, MRI, CT enhanced-scan, serum AFP monitoring.Materials and methods:Selection in our hospital inpatient treatment into standard not surgical removal of 40 patients with liver cancer as the objects, First treatment with TACE, then walk argon-helium cryoablation therapy in 4 weeks. All of the patients in the argon helium knife frozen ablation line 1,4 month after liver b value of diffusion weighted imaging and phase dynamic enhanced MRI (DCE-MRI) scan and CT enhanced scan. Through division within three subtropical high above expert reading alone, determine the characteristics of lesions after treatment, were divided into focal necrosis, residue, new kitchen oven. To compare the evaluation value Of hepatocellular cancer activity after treatment of TACE combined with argon-helium knife cryotherapy by double exponential model DWI imaging and single index model DWI imaging,, MRI, CT enhanced-scan, serum AFP monitoring.To take advantage of GE AW4.6 workstations image post-processing, Generate inactive, oven, stove and new stove residual single DWI imaging can regular ADC values and double index DWI imaging missile ADC, f and can fast ADC values, and statistical analysis, compare the liver single value b, b value of diffusion weighted imaging evaluation of intrahepatic tumor residual positive rate, sensitivity and specificity.Result:(1) CT scan and MRI scan and enhancement, enhanced after sequential argon-helium knife with conventional treatment of liver cancer lesions detected no significant difference between the number (P= 0.076), but DWI with CT scan and enhanced scan can in the lesion properties between the difference was statistically significant (P= 0.000< 0.001).(2) CT scan and enhanced conventional sequential activity evaluation of lesions after argon-helium cryotherapy, frozen area scan low density focal obvious enhancement tips for active residual foci, but not obvious strengthening lesions difficult judgment; MRI scan and enhancement, necrosis foci T1WI has higher signal, T2WI for low signal, focal necrosis without reinforcement, STD residual carcinoma early reinforced irregular; DWI check can the new oven or stove, characterized by the entire lesion is relatively high, with b value increases, the lesions compared with the surrounding liver parenchyma was still obviously high signal.(3) Hepatocellular carcinoma after interventional therapy more than b value of DWI imaging can focal necrosis, residue, new ADC of the oven, oven missile ADC and f value significantly different; Residual or new ADC of the oven, oven missile ADC values significantly lower than the focal necrosis, with significant statistical significance (P< 0.01).(4) DWI imaging can IVIM model for sequential argon-helium knife after the treatment of liver cancer with conventional activity evaluation, when the boundary value ADC= 1.29 ×10-3 mm/s, diagnostic sensitivity and specificity of the activity of liver cancer were 77.0%,90.8%; When the world value the slow ADC= 1.18 x 10"3 mm2/s, diagnostic sensitivity and specificity of the activity of liver cancer were 82.5%,95.9%; CT enhancement when CT net added value bound to take 14.4 Hu, diagnostic sensitivity and specificity of the activity of liver cancer was 75.0%,85.7% respectively.(5) Conventional sequential argon-helium knife cryotherapy after and before treatment before (after conventional argon helium knife), serum AFP level declined obviously, there is statistical significance (P= 0.007< 0.05), but only 27.5% of the serum AFP positive rate.Conclusion:(1)Diffusion weighted imaging IVIM model to evaluate liver cancer in curative effect is superior to single index DWI imaging and enhanced CT examination can;(2) The assessment sequential argon-helium knife treatment curative effect with conventional value of liver cancer by Voxel irrelevant movement (IVIM) double exponential model liver b value scanning technology, is obviously better sensitive than single index model DWI imaging and computed tomography (CT) can enhance the inspection.