| Objective:To analyze the feasibility of 3.0T functional magnetic resonance imaging index in evaluating the effectiveness of the trans-catheter arterial chemoembolization combined with Brucea javanica oil for hepatocellular carcinoma.Methods:It's a prospective experimental study.Sixty patients with primary hepatocellular carcinoma from Jun.2012 to Mar.2015 were randomly divided into Brucea javanica oil embolization group(BJO group,n=30)and control group(n=30),and all patients undergoing functional magnetic resonance imaging 1 week before and 1 month after treatment,including diffusion weighted imaging(DWI),magnetic resonance spectroscopy(MRS),dynamic contrast enhancement magnetic resonance imaging(DCE-MRI).Measureing apparent diffiusion coefficient(ADC),choline(Cho)peak,glycogen and glycogen compounds(Glyu)peak,lactic acid(Lac)peak,creatine(Cr)peak,lipid(Lip)peak and peak area ratio,volume transfer constant(Ktrans),interstitium-to-plasma rate constant(kep),fractiona lextracellular space volume(Ve),plasma volume fraction(Vp),hepatic arterial perfusion index(HPI).Recording alpha fetoprotein(AFP)and liver function 1 week before treatment,to calculate the tumor necrosis rate and survival time.All patients were treated with hepatic artery chemoembolization therapy,but the patients of BJO group were added with Brucea javanica oil.Using statistic software SPSS 21.0:to use t test comparing the measuring indexes between the two groups,?2 test comparing the count indicators.We then analyzed the relationship between 3.0 T MRI imaging index changes and the clinical curative effect by Linear correlation analysis.Finally,we use Log-Rank test to analyze the two groups of survival curves.Results:1?There was a significant difference between the two groups(P<0.05)for AFP which was obviously decreased after treatment in the BJO group and tumor necrosis rate which was obviously increased.2?There was a significant difference between the two groups(P<0.05)for total bilirubin(TBil)which was obviously decreased after treatment in the BJO group.3?There was a significant difference between the two groups(P<0.05)for Cho/Lip ratio which was obviously decreased after treatment in the BJO group.The Ktrans value and Kep value were lower and the ADC value was higher in the BJO group than in the control group after tretment,there was a significant difference between the two groups(P<0.01).4?The Ktrans reduction demonstrated a positive correlation with tumor necrosis rate(r= 0.635,P<0.01).5?The overall survival time of the two groups:BJO group 29±9.532 month;the control group 26±9.299 month;Log-Rank test ?2=4.249,P=0.039.Conclusion:1.In the aspect of AFP decrease rate,tumor necrosis rate and survival time,the BJO group was superior to the control group.2.The fMRI indexes of ADC?Cho/Lip ratio?Ktrans?Kep values had high value in assessing the effectiveness of hepatocellular carcinoma by Brucea javanica oil combined with transcatheter arterial chemoembolization. |
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