目的:分析肝恶性肿瘤钇‑90选择性内放射治疗（yttrium‑90 selective internal radiation therapy，⁹⁰Y‑SIRT）后的影像学表现及肿瘤缓解情况，探讨肿瘤实际吸收剂量与肿瘤缓解之间的关系。 方法:收集⁹⁰Y‑SIRT后进行⁹⁰Y PET/CT和MRI评估的44例肝恶性肿瘤患者资料，其中肝原发肿瘤（原发）组34例，肝继发肿瘤（继发）组10例，通过χ检验比较组间特征。采用mRECIST和RECIST1.1标准评估疗效，计算肿瘤在MRI上的缓解率；以3个月后的肿瘤应答为参考，探讨MRI‑DWI、MRI增强和肿瘤标志物在早期疗效评估上的诊断效能；通过Spearman相关性分析方法探究肿瘤实际吸收剂量与肿瘤缓解之间的关系。 结果:治疗后1个月原发组和继发组的缓解率分别为68.7%和0.0%，3个月分别为72.2%和40.0%，6个月分别为83.3%和33.3%。肿瘤实际吸收剂量与影像缓解率之间无相关性（ρ=0.061，P=0.764）。治疗后1个月MRI‑DWI、MRI增强和肿瘤标志物评价肿瘤早期应答能力的灵敏度分别为88.24%、73.33%、58.82%，特异度分别为16.67%、71.43%和57.14%。 结论:肝恶性肿瘤⁹⁰Y‑SIRT治疗后具有较好的影像缓解率，原发组缓解率较继发组高；DWI和肿瘤标志物在反映肿瘤早期应答能力方面具有较高的灵敏度；肿瘤实际吸收剂量与影像缓解率在统计学上无相关性。

Objective:To analyze the imaging findings and tumor remission after yttrium‑90 selective internal radiotherapy （⁹⁰Y‑SIRT） for liver malignant tumors， and to explore the relationship between actual absorbed dose of tumor and tumor remission. Methods:The data of 44 patients with hepatic malignant tumors evaluated by ⁹⁰Y PET/CT and MRI after ⁹⁰Y‑SIRT were collected， including 34 patients with primary hepatic malignant tumors （primary group） and 10 patients with secondary malignant tumors （secondary group）. The characteristics between groups were compared using χ test. The curative effect was evaluated by mRECIST and RECIST1.1 criteria， and the remission rate of tumor on MRI was calculated. With the tumor response after 3 months as a reference， the diagnostic efficacy of MRI‑DWI， MRI enhancement， and tumor markers in early efficacy evaluation was investigated. The relationship between actual absorbed dose of tumor and tumor remission was explored by Spearman correlation analysis. Results:One month after treatment， the remission rates of primary group and secondary group were 68.7% and 0.0%， respectively. After 3 months， the remission rates of primary group and secondary group were 72.2% and 40.0%， respectively， and those of 6 months were 83.3% and 33.3%， respectively. There was no correlation between the actual absorbed dose of tumor and imaging remission rate （ρ=0.061， P=0.764）. One month after the treatment， the sensitivity of MRI‑DWI， MRI enhancement，and tumor markers to evaluate tumor early response was 88.24%， 73.33%， and 58.82%， respectively， and the specificity was 16.67%， 71.43%， and 57.14%， respectively. Conclusion:There is a good imaging remission rate after ⁹⁰Y‑SIRT treatment for liver malignant tumors， and the remission rate in the primary group is higher than that in the secondary group. DWI and tumor markers have high sensitivity in reflecting the early response ability of the tumor， and there is no statistical correlation between the actual absorbed dose of the tumor and imaging remission rate.

R735.7

海南省卫生健康行业科研项目（22A200294）；海南省临床医学研究中心项目（LCYX202403）