| Objective:To evaluate the characteristics of the lesions in the epidermal diffusion imaging before and after interventional therapy of hepatocellular carcinoma?HCC?in order to explore the value of the apparent diffusion coefficient in assessing the interventional therapy of patients with hepatocellular carcinoma.The treatment provides an early and reasonable assessment and treatment program.Materials and methods:A retrospective analysis of 47 patients with primary hepatocellular carcinoma?60patients,aged 35-73 years,51.40±7.20 years?from July 2014 to September 2016 in the Affiliated Hospital of Taishan Medical College.The diagnostic criteria of primary liver cancer to meet the Chinese anti-cancer Association of liver cancer professional committee developed in 2001 Guangzhou standard[1];all patients had no other history of tumor,no surgery history.Patients underwent TACE treatment;intraoperative abdominal MRI?including DWI scan?within 1 week and 1 month after surgery;6 to 12 months after surgery to accept the upper abdomen MRI review;the upper abdomen MRI examination of the image quality Meet the diagnostic and measurement needs.Combined with MRI images of 6-12 months before and after each patient,the progress of the lesion was evaluated using the internationally accepted mRECIST standard[2],and the patients were included in the progression group or non progressive group.The specific criteria for the progress group were:6 to 12 months postoperative MR findings found that the diameter of the target lesion was at least 20%higher and/or had a new lesion in the MR scan prior to 1week before surgery;the remaining patients were included Progress group.Results:According to the mRECIST criteria,36 patients in 36 patients were included in the progressive group and 11 patients were included in the non-progression group.The ADC values of the progressive group were significantly higher than those of the non-advanced group?P<0.05?.The ADC value of the progressive group was 0.64×10-3mm2/sec in the advanced group.0.69×10-3mm2/sec;ADC values between the two groups were statistically significant?P=0.046;t=2.056?.The ADC values were used to differentiate between the progression group and the non-progression group.The ROC curve was plotted with different ADC values as the critical point.The area under the curve was 0.716,and the optimal threshold Was 0.69×10-3mm2/sec,the lesion ADC with the ADC value below this threshold was judged as the progressive group.The ADC with the ADC value higher than this threshold was judged as non-advanced group,the sensitivity was 77.8%and the specificity was 63.6%,The accuracy is 74.5%.The difference between the ADC values and the ADC value of the non-progressive group was 3.16cm in the intrahepatic lesions of the non-progressive group and the mean diameter in the 1 month after operation.?P=0.583;t=0.567?.There was no significant difference between the two groups?P>0.05?.?P=0.785;t=0.276?.There was no significant difference in ADC value between the two groups?P=0.785;t=0.276?.The ADC values of the patients in the progressive group were 0.65×10-3mm2/sec within 1 month after operation,and there was no significant difference?P<0.05?between the ADC values(0.64×10-3mm2/sec);?P=0.125;t=1.571?.The ADC value of the non-progressive group was 0.76×10-3mm2/sec after 1 month of intrahepatic lesions,and the ADC value(0.69×10-3mm2/sec)Significant statistical difference?P=0.000<0.05;t=6.804?.The difference between the progression group and the non-progression group was compared using the difference between the ADC values at 1week before and 1 month after the progress group and the non progressing group.The difference was the critical point to judge whether the lesion progressed and plotted the ROC curve,The area under the curve was 0.966,and the optimal threshold was0.03×10-3mm2/sec,and the ADC with the ADC value below the threshold was judged as the progressive group.The ADC value was higher than this threshold The sensitivity of the threshold was 88.9%,the specificity was 100%,and the accuracy was 91.5%. |
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