Keywords:
Abdomen, Liver, Radiographers, MR-Diffusion/Perfusion, MR, Surgery, Ablation procedures, Efficacy studies, Cancer, Metastases
Authors:
V. Vdovenko, N. A. Karelskaya, G. Karmazanovsky, Y. Galchina, D. Ionkin, A. Chzhao; Moscow/RU
DOI:
10.26044/ecr2019/C-2000
Methods and materials
During the period of 2012-2017 CD was performed in 59 patients with liver tumors. Dynamic postoperative MRI monitoring was carried out in 15 patients with malignant liver lesions (5 patients with primary liver tumors,
10 - with secondary liver lesions) (Fig.1).
All patients underwent MRI with DWI before surgery and in the postoperative period on the 1st day,
3 months,
6 and 12 months.
All patients were divided into two groups.
The first group (5 out of 15 patients,
33.3%) consisted of patients with adequately performed CD,
MRI on the 1st day after CD showed the target lesion was totally overlapped by the area of the postoperative edema.
In second group (10 out of 15 patients-66.7%) on the 1st day after CD liver lesions were not covered by the CD edema zone,
which was subsequently noted as incomplete "overlap" of the pathological focus or inadequately performed CD (Fig.2).
MR study was performed on high field MR tomograph 3.0 T using a 16-channel sense torso XL coil.
The MR scanning protocol included imaging in axial projection with trigger respiratory synchronization (T1 -,
T2- weighted images with high resolution and DWI with apparent diffusion coefficient calculating (ADC maps).
The sizes of the focus before the operation and in the long-term period after CD,
changes of diffusion restriction in the area of interest,
"overlapping" of the pathological focus by postoperative edema zone on the 1st day after CD with the subsequent formation of the assumption about the continuation of growth were estimated.
ADC was determined using a round ROI (region of interest) in the CD zone.
In the presence of necrotic changes in the zone of interest,
only a solid component was included.
If it was impossible to carry out measurements due to the presence of artifacts in the area of interest,
the measurements were carried out in a visually homogeneous area.