[1]马 超,王 艳,李 辉.磁共振钆塞酸二钠增强对肝细胞癌TACE术后疗效的评估价值[J].介入放射学杂志,2026,(09):992-997.[doi:10.3969/j.issn.1008-794X.2026.09.005]
 MA Chao,WANG Yan,LI Hui..Application of gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid enhanced magnetic resonance imaging in evaluating the postoperative efficacy of TACE for hepatocellular carcinoma[J].J Intervent Med,2026,(09):992-997.[doi:10.3969/j.issn.1008-794X.2026.09.005]
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磁共振钆塞酸二钠增强对肝细胞癌TACE术后疗效的评估价值()

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《介入放射学杂志》[ISSN:1008-794X/CN:31-1796/R]

卷:
期数:
2026年09
页码:
992-997
栏目:
肿瘤介入
出版日期:
2026-09-10

文章信息/Info

Title:
Application of gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid enhanced magnetic resonance imaging in evaluating the postoperative efficacy of TACE for hepatocellular carcinoma
文章编号:
1008-794X(2026)-009-0992-06
作者:
马 超 王 艳 李 辉
830000 新疆乌鲁木齐 新疆维吾尔自治区人民医院放射影像中心
Author(s):
MA ChaoWANG YanLI Hui.
Radiology Imaging Center,People's Hospital of Xinjiang Uygur Autonomous Region,Urumqi,Xinjiang Uygur Autonomous Region 830000,China
关键词:
肝细胞癌 经肝动脉化疗灌注栓塞术 肿瘤存活 钆塞酸二钠 磁共振
分类号:
R735.7
DOI:
10.3969/j.issn.1008-794X.2026.09.005
文献标志码:
A
摘要:
目的 分析磁共振(MRI)钆塞酸二钠(Gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid,Gd-EOB-DTPA)增强用于肝细胞癌(HCC)患者首次经肝动脉化疗灌注栓塞术(TACE)疗效评估的价值。方法 选取2020年11月至2024年6月新疆维吾尔自治区人民医院收治的HCC患者105例,所有患者在TACE术前及术后3个月内均接受Gd-EOB-DTPA增强MRI检查,根据肝脏成像报告和数据系统(LI-RADS)疗效评价标准将检查结果分为肿瘤存活、肿瘤无存活、肿瘤存活判断困难,使用Cohen's Kappa一致性评估两名阅片者的判断一致性; 以术后3个月内数字减影血管造影(DSA)或病理检查结果+随访6个月的MRI检查为肿瘤存活(TACE无效)或无存活(TACE有效)的金标准,根据MRI影像学特征分为4种判断方法:A法(LI-RADS疗效评价标准中肿瘤存活为治疗无效)、B法(LI-RADS疗效评价标准中肿瘤存活+肿瘤存活判断困难为治疗无效)、C法(LI-RADS疗效评价标准中肿瘤存活+Gd-EOB-DTPA增强MRI特征信号为治疗无效)、D法(LI-RADS疗效评价标准中肿瘤存活+肿瘤存活判断困难+Gd-EOB-DTPA增强MRI特征信号为治疗无效),分别计算4种判断方法对TACE疗效的诊断价值。结果 105例HCC患者有3例术后未遵医嘱随访,予以剔除,102例最终入组的HCC患者共124个病灶。两名阅片者对LI-RADS疗效观察一致性的Kappa系数为0.761(P<0.05),对Gd-EOB-DTPA增强MRI肝胆期特征信号观察一致性的Kappa系数为0.873(P<0.05)。A法、B法、C法、D法与金标准的Kappa系数分别为0.640、0.741、0.814、0.850(均P<0.05)。D法的灵敏度及准确度最高,分别为93.88%、92.74%,显著高于A法(P<0.05),C法的灵敏度也显著高于A法为87.76%比61.22%(P<0.05)。结论 基于Gd-EOB-DTPA增强MRI检查的LI-RADS疗效标准联合肝胆期特征信号对判断HCC患者TACE疗效准确性较高,可指导临床治疗决策。

参考文献/References:

[1] 张 辉,张庆桥,袁 磊,等.CalliSpheres D-TACE与c-TACE治疗原发性肝癌对肝纤维化和肝功能的影响[J].介入放射学杂志,2024,33:259-263.
Zhang H,Zhang Q Q,Yuan L,et al.The effect of CalliSpheres DEB-TACE and c-TACE on liver fibrosis and liver function in treating primary hepatocellular carcinoma[J],J Intervent Radiol,2024,33:259-263.
[2]Yuan Y,He W,Yang Z,et al.TACE-HAIC combined with targeted therapy and immunotherapy versus TACE alone for hepatocellular carcinoma with portal vein tumour thrombus:a propensity score matching study[J].Int J Surg,2023,109:1222-1230.
[3]Fan W,Zhu B,Chen S,et al.Survival in patients with recurrent intermediate-stage hepatocellular carcinoma:sorafenib plus TACE vs TACE Alone Randomized Clinical Trial[J].JAMA Oncol,2024,10:1047-1054.
[4]Ai X,Wang H,Yang Y,et al.Four indices on Gd-EOB-DTPA-enhanced MRI can estimate liver functional reserve compared to ICG-R15:a systematic review and meta-analysis[J].Clin Imaging,2023,102:1-8.
[5]Yan M,Zhang X,Zhang B,et al.Deep learning nomogram based on Gd-EOB-DTPA MRI for predicting early recurrence in hepatocellular carcinoma after hepatectomy[J].Eur Radiol,2023,33:4949-4961.
[6]Wang D,Zhang Y,Lyu R,et al.LI-RADS version 2018 treatment response algorithm on extracellular contrast-enhanced MRI in patients treated with transarterial chemoembolization for hepatocellular carcinoma:diagnostic performance and the added value of ancillary features[J].Abdom Radiol(NY),2024,49:3045-3055.
[7]中华人民共和国国家卫生健康委员会医政医管局.原发性肝癌诊疗规范(2019年版)[J].中华消化外科杂志,2020,19:1-20.
Medical Administration Bureau of the National Health Commission of the People's Republic of China.Standardization for diagnosis and treatment of hepatocellular carcinoma(2019 edition)[J].Chin J Digest Surg,2020,19:1-20.
[8]Kanmaniraja D,Dellacerra G,Holder J,et al.Liver Imaging Reporting and Data System(LI-RADS)v2018:Review of the CT/MRI diagnostic categories[J].Can Assoc Radiol J,2021,72:142-149.
[9]Kim SW,Joo I,Kim HC,et al.LI-RADS treatment response categorization on gadoxetic acid-enhanced MRI:diagnostic performance compared to mRECIST and added value of ancillary features[J].Eur Radiol,2020,30:2861-2870.
[10]Liu B,Zhang Y,Chen H,et al.The combination of transcatheter arterial chemoembolisation(TACE)and thermal ablation versus TACE alone for hepatocellular carcinoma[J].Cochrane Database Syst Rev,2022,1:CD013345.
[11]Mo A,Lin B,Chen D.Efficacy of sequential TACE on primary hepatocellular carcinoma with microvascular invasion after radical resection:a systematic review and meta-analysis[J].World J Surg Oncol,2023,21:277-287.
[12]Liu D,Qiao Z,Xu L,et al.Gd-EOB-DTPA enhanced MRI features of liver hemangiomatosis coexistent with GCH[J].Curr Med Imaging,2022,18:1390-1395.
[13]Bhattacharyya T,Mallett CL,Shapiro EM.MRI-based cell tracking of OATP-expressing cell transplants by pre-labeling with Gd-EOB-DTPA[J].Mol Imaging Biol,2024,26:233-239.
[14]Mao Y,Wang J,Zhu Y,et al.Gd-EOB-DTPA-enhanced MRI radiomic features for predicting histological grade of hepatocellular carcinoma[J].Hepatobiliary Surg Nutr,2022,11:13-24.
[15]悦笑斐,杨红丽,吴林霞,等.基于MRI的LI-RADS 2018版评价肝癌介入术后肿瘤活性的研究[J].临床放射学杂志,2022,41:2236-2240.
Yue X F,Yang H L,Wu L X,et al.LI-RADS Version 2018 for evaluating tumor viability of hepatocellular carcinoma after interventional procedures on MRI[J].J Clin Radiol,2022,41:2236-2240.
[16]Yu Y,Fan Y,Wang X,et al.Gd-EOB-DTPA-enhanced MRI radiomics to predict vessels encapsulating tumor clusters(VETC)and patient prognosis in hepatocellular carcinoma[J].Eur Radiol,2022,32:959-970.
[17]Zheng R,Zhang X,Liu B,et al.Comparison of non-radiomics imaging features and radiomics models based on contrast-enhanced ultrasound and Gd-EOB-DTPA-enhanced MRI for predicting microvascular invasion in hepatocellular carcinoma within 5 cm[J].Eur Radiol,2023,33:6462-6472.
[18]Shi Z,Cai W,Feng X,et al.Radiomics analysis of Gd-EOB-DTPA enhanced hepatic MRI for assessment of functional liver reserve[J].Acad Radiol,2022,29:213-218.
[19]Marth AA,Auer TA,Walter-Rittel TC,et al.Gd-EOB-DTPA-MRCP to localize bile leakage after liver trauma and surgery:impact on treatment and outcome[J].Eur Radiol,2023,33:5933-5942.
[20]Kuwano A,Tanaka K,Yada M,et al.Therapeutic efficacy of lenvatinib for hepatocellular carcinoma with iso-high intensity in the hepatobiliary phase of Gd-EOB-DTPA-MRI[J].Mol Clin Oncol,2022,16:53-62.
[21]Inokuchi Y,Fujikawa H,Uematsu M,et al.Transitional phase Gd-EOB-DTPA-enhanced MRI:Visual assessment of hepatic function and fibrosis based on uptake rate of Gd-EOB-DTPA[J].Eur J Radiol,2022,156:e110550.
(收稿日期:2025-09-24)
(本文编辑:新 宇)

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备注/Memo

备注/Memo:
基金项目: 新疆维吾尔自治区人民医院院内项目(20230236)
通信作者: 马 超 E-mail:mcjj456@163.com
更新日期/Last Update: 2026-09-25