IVIM在评价肝癌TACE治疗反应的应用

1、1会计学IVIM在评价肝癌在评价肝癌TACE治疗反应的应用治疗反应的应用 水分子的布朗运动： 微观环境内的随机运动。 DWI和IVIM的成像基础=&b=0 b=1000 ADCADC=ln(S低/S高)/(b高-b低)通过两个以上不同b值DWI图即可算出ADC图。 Sb/S0=(1-f)exp(-bD)+fexp-b(D+D*)S：体素内信号强度。D扩散系数：纯的水分子扩散效应。D*假性扩散系数：由于微循环的灌注所致扩散效应。 f灌注分数：局部微循环灌注占总扩散效应容积比。 通过多个b值DWI图即可算出IVIM相关数值的图。 磁共振弥散加权成像（MR diffusion-weighte

2、d imaging，DWI）是能在活体组织中检测水分子自由扩散运动(布朗运动)无创影像检查技术DWI使人体的研究深入到分子水平DWI可反应微观结构和功能变化DWI可定量评估病灶结构肝癌TACE治疗后，细胞数目减少，细胞间隙增大，肿瘤细胞坏死，细胞膜等结构溶解和破坏，水分子弥散增强，ADC值增高 肝癌TACE治疗后肿瘤残存或复发时，ADC值则不升高，甚至降低Serial diffusion-weighted MRI in patients with hepatocellular carcinoma: Prediction and assessment of response to transar

3、terial chemoembolizationThirty-six patients with HCC who underwent TACE and MRI (included DWI) before and after TACE were assessed Pre-, post-TACE tumor ADC, and changes in tumor ADC (ADC) were compared between lesions stratified by degree of tumor necrosis (measured on post-TACE MRI) EJR. 2013 Apr;

4、82(4):577-82.HCCs with poor and incomplete response to TACE had significantly lower pre-treatment ADC and lower post TACE ADC compared to HCCs with good/completeThere was no difference in ADC values EJR. 2013 Apr;82(4):577-82.DWI的不足： EPI存在相关的伪影，如变形伪影肝内良、恶性结节的ADC值具有一定重叠，其鉴别尚需要结合病史或其他检查结果影响ADC值得因素较多，包

5、括MR设备类型、扫描参数（TR及TE）、b值、ROIIntravoxel incoherent motion (IVIM)MR imaging是以DWI为基础的多b值扩散加权成像分别获取真实扩散及局部灌注扩散与DWI相比，IVIM能更好地反应病灶真实扩散，有利于病灶坏死、复发、转移等性质的辨别。在两组中，D*值具有显著性差异，ADC，D，f值无显著性差异表一 肝癌介入前与介入后IVIM参数ADCDD*f介入前1.220.161.030.1624.945.7825.026.94介入后1.320.191.110.2822.918.4222.256.95p0.030.0070.2290.009结论：

6、 肝癌介入后，ADC、D值升高，D*、f值降低。 按p=0.05检验水准，可认为肝癌介入前后ADC值、D值、f值不同， 此值可用于评价肝癌介入疗效。评价指标等级为D值f值ADC值。 按p=0.05检验水准，肝癌介入前后D*值无明显变化。Serial diffusion-weighted MRI in patients with hepatocellular carcinoma: Prediction and assessment of response to transarterial chemoembolizationThirty-six patients with HCC who underwent TACE and MRI (included DWI) before and after TACE were assessed Pre-, post-TACE tumor ADC, and changes in tumor ADC (ADC) were compared between