| 陈丽华,刘爱连,宋清伟,汪禾青,孙美玉,解立志.磁共振扩散张量成像鉴别诊断肝内胆管细胞癌与肝细胞癌[J].中国医学影像技术,2017,33(7):993~997 |
| 磁共振扩散张量成像鉴别诊断肝内胆管细胞癌与肝细胞癌 |
| Diffusion tensor imaging in differential diagnosis of intrahepatic cholangiocarcinoma and hepatocellular carcinoma |
| 投稿时间：2016-11-29 修订日期：2017-02-22 |
| DOI：10.13929/j.1003-3289.201611140 |
| 中文关键词: 扩散磁共振成像 肝内胆管细胞癌 癌，肝细胞 |
| 英文关键词:Diffusion magnetic resonance imaging Intrahepatic cholangiocarcinoma Carcinoma, hepatocellular |
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| 中文摘要: |
| 目的 探讨磁共振扩散张量成像（DTI）鉴别肝内胆管细胞癌（ICC）和肝细胞癌（HCC）的价值。方法 回顾性分析在我院接受肝脏MR检查并经病理证实的ICC 20例（ICC组）、HCC 32例（HCC组）。所有患者均接受1.5T MRI常规T1WI、T2WI、DWI及DTI序列扫描，观察病变影像学特征。由2名观察者独立测量两组病灶DTI的弥散系数（D）值、各向异性分数（FA）值及DWI的ADC值，分析其测量的一致性并进行组间比较。对有统计学差异的参数，绘制ROC曲线，分析诊断效能及阈值。结果 ICC组9例（9/20，45.00%）病灶边界清晰，HCC组15例（15/32，46.88%）边界清晰，差异无统计学意义（χ2=0.02，P=0.90）。ICC组11例（11/20，55.00%）可见邻近胆管扩张，高于HCC组（4/32，12.50%），差异有统计学意义（χ2=10.83，P=0.001）。2名观察者测得的2组各参数结果一致性良好，相关系数值均大于0.90。ICC组FA值（0.45±0.16）高于HCC组（0.30±0.13），差异有统计学意义（P=0.001）；2组的ADC值和D值差异均无统计学意义（P均>0.05）。FA值ROC曲线下面积为0.76，在界值为0.31时，鉴别诊断ICC与HCC的敏感度（85.0%）较高。结论 DTI的FA值对鉴别ICC与HCC有较高的诊断效能，可以为临床提供重要参考。 |
| 英文摘要: |
| Objective To explore the value of diffusion tensor imaging (DTI) in differential diagnosis of intrahepatic cholangiocarcinoma (ICC) and hepatocellular carcinoma (HCC). Methods Fifty-two patients including 20 patients with ICC (ICC group) and 32 patients with HCC (HCC group) confirmed by histopathological examination were recruited in the study. All the patients were performed MR exams on a 1.5T scanner in a protocol containing the routine T1WI, T2WI, DWI and DTI. The values of ADC, fractional anisotropy (FA), diffusion coefficient (D) were blindly reviewed and analyzed by two experienced observers, and were compared between two groups. The ROC curve was used to evaluate the diagnostic efficiency. Results The border clear percentage of ICC group (9/20, 45.00%) had no significant difference compared with that of HCC group (15/32, 46.88%; χ2=0.02, P=0.90), the detection rate of bile duct expansion in ICC group (11/20, 55.00%) was higher than that in HCC group (4/32, 12.50%; χ2=10.83, P=0.001). The intraclass correlation coefficient value of ADC, D and FA in the ICC group and HCC group were all more than 0.90. The mean FA of ICC group (0.45±0.16) were significantly higher than that of HCC group (0.30±0.13; P=0.001), while the mean ADC and D values in ICC and HCC groups had no significant difference (both P>0.05). The area under the ROC curve of FA was 0.76. And when FA=0.31, there was a higher sensitivity (85.0%) in identifying ICC and HCC. Conclusion The FA of DTI shows a stronger capability than the ADC and D values in differentiating the ICC from HCC. |
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