IVIM扩散加权成像在氩氦刀冷冻治疗原发性肝癌中的作用

摘要/Abstract

摘要： 目的探讨体素内不相干运动(IVIM)扩散加权成像(DWI)在氩氦刀冷冻治疗原发性肝癌患者中的作用。方法选择2016年2月至2019年7月新乡医学院第三附属医院收治的112例原发性肝癌患者。氩氦刀冷冻治疗术前1 d、术后1个月采用IVIM-DWI检查,根据患者术后是否复发分为复发组和未复发组,比较复发组与未复发组手术前后IVIM-DWI参数。logistic回归分析原发性肝癌术后复发的影响因素,以受试者工作特征曲线(ROC)判定IVIM-DWI参数对原发性肝癌患者术后复发的预测价值。结果随访1年,112例患者中,复发16例(14.29%),未复发96例。复发组肿瘤大小为(36.58±4.32)mm,未复发组为(30.17±3.76)mm(P<0.05)。复发组术后标准表现扩散系数(ADC)、术后纯扩散系数(D)比未复发组低(P<0.05)。复发组TNM分期为Ⅱ期例数占比比未复发组高(P<0.05)。logistic多因素回归分析结果显示,术后ADC值、术后D值、肿瘤大小为原发性肝癌术后复发的影响因素(P<0.05)。ROC结果显示,术后D值、ADC值对原发性肝癌术后复发具有一定的预测效能(P<0.05)。结论原发性肝癌患者经氩氦刀冷冻治疗术后1个月的IVIM-DWI参数D值、ADC值对预测原发性肝癌复发具有一定的价值。

关键词: 氩氦刀冷冻, 原发性肝癌, 体素内不相干运动扩散加权成像, 影响因素, 预测价值

Abstract: Objective To explore the guiding role of Intravoxel Incoherent Motion (IVIM) Diffusion-Weighted Imaging (DWI) in the curative effect of argon-helium cryotherapy for patients with primary liver cancer (PLC).Methods A total of 112 patients with PLC admitted to the hospital from February 2016 to July 2019 were selected as the research objects. The patients were all treated with cryotherapy with argon helium knife. The patients were examined by IVIM-DWI at 1 day prior and 1 month after the operation. They were followed up for 1 year and divided into recurrence group and non-recurrence group according to whether their PLC recurred after operation. The clinical data and IVIM-DWI parameters before and after surgery in these two groups were collected and compared. Logistic regression analysis was used to explore the factors affecting the recurrence of PLC. The receiver operating characteristic curve (ROC) was used to determine the predictive value of IVIM-DWI parameters for postoperative recurrence of patients with PLC.Results After a 1-year’s follow-up, 112 patients with PLC received cryotherapy with argon-helium knife. There were 16 (14.29%) cases in the recurrence group and 96 cases in the non-recurrence group. The tumor size of the recurrence group was higher than that of the non-recurrence group (P<0.05). The standard postoperative diffusion coefficient (ADC) and postoperative pure diffusion coefficient (D) of the recurrence group were lower than those of the non-recurrence group (P<0.05). The proportion of cases with TNM staging of stage II in the recurrence group was higher than that in the non-recurrence group (P<0.05). Logistic multivariate regression analysis showed that postoperative ADC value, postoperative D value, and tumor size were all influencing factors for the recurrence of PLC (P<0.05). The ROC analysis showed that the postoperative D and ADC values have a certain diagnostic power in predicting the recurrence of PLC after surgery (P<0.05).Conclusion The D and ADC values of IVIM-DWI parameters of PLC patients at one month post cryotherapy with argon-helium knife cryotherapy have certain efficacies in predicting the recurrence of PLC.

Key words: Argon-helium knife freezing, Primary liver cancer, Diffusion-weighted imaging of incoherent motion within voxel, Influencing factors, Predictive value

马军伟, 柳计强, 宋冉. IVIM扩散加权成像在氩氦刀冷冻治疗原发性肝癌中的作用[J]. 肝脏, 2022, 27(7): 778-781.

MA Jun-wei, LIU Ji-qiang, SONG Ran. The guiding value of intravoxel incoherent motion diffusion-weighted imaging in the curative effect of argon-helium knife cryotherapy on primary liver cancer[J]. Chinese Hepatolgy, 2022, 27(7): 778-781.

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