磁共振成像评价肝癌TACE术后疗效的应用进展

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摘要经导管肝动脉化疗栓塞术（TACE）是治疗不能手术切除的中晚期肝癌的主要手段。但是肝癌TACE术难以使肿瘤完全坏死达到根治的目的，复发率高，需多次行TACE术。因此术后定期随访，早期发现存活癌灶及复发灶、及时治疗是取得良好疗效的重要条件。传统方法使用肿瘤的大小来评估肿瘤的反应，有一定的局限性。目前认为以DWI、MRS为代表的MRI功能成像技术，能够在肿瘤发生形态学变化之前，通过提供体内的生理和代谢变化等信息，有助于早期判断肝癌的介入治疗疗效。但是单一的MRI功能成像技术并不能完全取代常规平扫及增强检查，往往需要多种扫描序列联合运用。MRI多种成像技术联合运用，能够从多个角度、早期、全面的分析和判断肝癌TACE术后肿瘤有无残留或复发。随着MRI软硬件技术的不断发展，MRI将有望成为肝癌TACE术后疗效判断及随访观察的有效手段。

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	王莉
	赵冬梅
	韩福刚

关键词 ：肝肿瘤, 放射学, 介入性, 磁共振成像

Abstract：Transcatheter arterial chemoembolization(TACE) is the major means of treatment in patients with unresectable middle-late stage of hepatocellular carcinoma. However, TACE of hepatocellular carcinoma is hard to make the tumor complete necrosis to achieve the purpose of cure, which leads to a high rate of recurrence. We have to take the TACE many times. Therefore, regular follow-up after the TACE, early detection of the cancer survival or recurrence, timely treatment are the important conditions to achieve a good effect. Traditional approaches use tumor size to evaluate tumor response, which has several limitations. At present, DWI and MRS as the representative of functional MRI could provide the information such as the physiological and metabolic changes in the body before the changes of the morphology. They will help to judge curative effect of interventional treatment of hepatocellular carcinoma early. But any single function imaging technology cannot replace the conventional MRI scan and contrast examination completely. Its often requires combination of multiple scan sequences. Combination of multiple imaging techniques of MRI could from various perspective, early, comprehensive analysis and judge whether there is a residual or recurrence of tumor after TACE. With the development of the software and hardware technology of MRI, MRI is expected to become an effective means in evaluation on therapeutic efficiency and follow-up observation of TACE of hepatocellular carcinoma.

Key words： Liver neoplasms Radiology, interventional Magnetic resonance imaging

收稿日期: 2015-05-26

PACS:	Ｒ735.7
	Ｒ815
	Ｒ445.2

通讯作者: 韩福刚

作者简介: 王莉（1989-），女，四川乐山人，在读硕士研究生。E-mail：445728734@qq.com

引用本文:

王莉，赵冬梅，韩福刚. 磁共振成像评价肝癌TACE术后疗效的应用进展[J]. 中国临床医学影像杂志, 2016, 27(2): 135-137.
WANG Li, ZHAO Dong-mei, HAN Fu-gang. Application of MRI in evaluation on therapeutic efficiency of transcatheter arterial chemoembolization of #br# hepatocellular carcinoma. JOURNAL OF CHINA MEDICAL IMAGING, 2016, 27(2): 135-137.

链接本文:

http://www.jccmi.com.cn/CN/ 或 http://www.jccmi.com.cn/CN/Y2016/V27/I2/135

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