Value of intravoxel incoherent motion diffusion weighted imaging (IVIM-DWI) in prediction of prognosis of hepatocellular carcinoma after transcatheter arterial chemoembolization

ZHU Zheng; ZHAO Xinming; ZHOU Chunwu; OUYANG Han; WANG Shuang; WANG Qian; SHI Zhuo

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Value of intravoxel incoherent motion diffusion weighted imaging (IVIM-DWI) in prediction of prognosis of hepatocellular carcinoma after transcatheter arterial chemoembolization

更新时间：2025-12-15

- Value of intravoxel incoherent motion diffusion weighted imaging (IVIM-DWI) in prediction of prognosis of hepatocellular carcinoma after transcatheter arterial chemoembolization
- Vol. 27, Issue 2, Pages: 82-87(2018)
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  CLC：
- Published Online：16 May 2018，
  
  Published：16 May 2018
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朱正,赵心明,周纯武,等. 体素内不相干运动扩散加权成像在肝癌介入治疗预后中的价值[J]. 肿瘤影像学, 2018, 27(2): 82-87
DOI：

朱正,赵心明,周纯武,等. 体素内不相干运动扩散加权成像在肝癌介入治疗预后中的价值[J]. 肿瘤影像学, 2018, 27(2): 82-87 DOI：

摘要

目的：

探讨MR体素内不相干运动扩散加权成像（intravoxel incoherent motion diffusion weighted imaging，IVIM-DWI）指标预测肝细胞肝癌（hepatocellular carcinoma，HCC）经动脉化疗栓塞（transcatheter arterial chemoembolization，TACE）后无进展生存期（progression-free survival，PFS）的价值。

方法：

收集2014年9月30日2017年9月30日于北京协和医院肿瘤医院诊治的90例肝癌患者，在治疗前及治疗后4~6周内分别行IVIM-DWI检查。将性别、年龄、病变长径、瘤栓有无、AFP、ALT值6个临床指标，治疗前ADC、D、D*、f值，以及治疗后ADC、D、D*、f值8个MR功能学定量指标进行多因素分析。采用独立样本t检验、方差分析及

检验，以Kaplan-Meier生存曲线、Log-Rank检验、多因素Cox回归分析确定有预后价值的IVIM参数及临床指标。

结果：

性别、年龄、治疗前D*值、治疗前f值及治疗后D*值共5个指标在肝癌TACE治疗后的PFS中差异具有统计学意义（

性别

=0.030，

年龄

=0.005，

治疗前D*

0.001，

治疗前f值

=0.007，

治疗后D*

0.001）。即男性、高龄、高治疗前D*值、高治疗前f值及高治疗后D*值的患者预后差。以中位数为分界值，即年龄、治疗前D*值、治疗前f值和治疗后D*值4个指标分别以53岁、14.110

-3

/s、23.63%和11.910

-3

/s为界值，发现年龄及治疗前D*值2个指标预测预后的差异有统计学意义（

高龄组

=0.027，

治疗前D*

=0.003）。

结论：

年龄及治疗前D*值2个指标有助于预测肝癌TACE治疗的预后，即高龄、高治疗前D*值者预后更差。

Abstract

Objective:

To predict the value of intravoxel incoherent motion diffusion weighted imaging (IVIM-DWI) in prediction of progression-free survival (PFS) of hepatocellular carcinoma (HCC) after transcatheter arterial chemoembolization (TACE).

Methods:

Ninety patients were enrolled in this study from September 30

2014 to September 30

2017. A total of 14 parameters including 6 clinical indexes: gender

age

size of lesion

tumor thrombus

AFP and ALT values; and 8 functional MRI indexes: pretreatment ADC

posttreatment ADC

D* and f were analyzed by multivariate analysis. Independent sample t test

ANOVA

Kaplan-Meier survival curve

Log-Rank test and Cox regression analysis were used to determinate the prognostic value of IVIM parameters and clinical indicators.

Results:

Gender

age

pretreatment D*

f and posttreatment D* could predict the prognosis of HCC after TACE (

gender

=0.030

age

=0.005

pretreatment D*

0.001

pretreatment f

=0.007，

posttreatment D*

0.001). Using median (age=53 years

pretreatment D*=14.110

-3

pretreatment f=23.63%

posttreatment D*=11.910

-3

/s) as cut-off value

age and pretreatment D* showed statistical significance in predicting the prognosis of HCC (

age

=0.027

pretreatment D*

=0.003).

Conclusion:

Age and pretreatment D* value can predict the prognosis of HCC after TACE.

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