| 李玉博,高雪梅,程敬亮,鲁果果.体素内不相干运动扩散加权成像在肝细胞癌术前分级中的应用[J].中国医学影像技术,2014,30(11):1669~1673 |
| 体素内不相干运动扩散加权成像在肝细胞癌术前分级中的应用 |
| Application of intravoxel incoherent motion diffusion weighted imaging on the preoperative grading of hepatocellular carcinoma |
| 投稿时间：2014-06-10 修订日期：2014-08-16 |
| DOI： |
| 中文关键词: 癌,肝细胞 扩散磁共振成像 |
| 英文关键词:Carcinoma, hepatocellular Diffusion magnetic resonance imaging |
| 基金项目: |
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| 中文摘要: |
| 目的 探讨应用体素内不相干运动扩散加权成像(IVIM DWI)对肝细胞癌(HCC)进行术前分级的可行性。方法 回顾性分析29例HCC患者的影像学资料及病理资料。以Edmondson-Steiner分级法为依据分为低级别组、高级别组, 均接受MRI及多b值DWI成像, 应用单双指数函数分别计算两组的标准ADC值、真实扩散系数(D值)、灌注相关扩散系数(D*值)及灌注分数(f值)。组间比较采用非参数检验Mann-Whitney U, DWI参数预测HCC分级效能的比较采用ROC曲线分析。结果 低级别组12例, 高级别组17例。低级别组标准ADC值、D值、D*值和f值分别为(1.29±0.27)×10-3 mm2/s、(1.21±0.36)×10-3 mm2/s、(40.20±7.79)×10-3 mm2/s、(23.97±9.22)%, 高级别组分别为(0.90±0.25)×10-3 mm2/s (0.75±0.20)×10-3 mm2/s、(53.40±11.99)×10-3 mm2/s、(32.24±12.66)%, 两组间标准ADC值、D值及D*值的差异有统计学意义(P均 <0.05), f值差异无统计学意义(P >0.05)。应用标准ADC值、D值、D*值鉴别诊断低级别与高级别HCC的曲线下面积依次为0.86、0.89、0.83;D值取阈值0.87×10-3 mm2/s时的敏感度和特异度分别为90.0%和80.0%。结论 应用IVIM DWI可以于术前预测HCC的病理学分级。 |
| 英文摘要: |
| Objective To explore the feasibility of intravoxel incoherent motion diffusion weighted imaging (IVIM DWI) in grading of the hepatocellular carcinoma (HCC) before the surgery. Methods The imaging and pathological data of 29 patients with HCC confirmed by pathology were analyzed retrospectively. All of them underwent MRI and DWI before the surgery and were divided into low grade group and high grade group according to the Edmondson-Steiner grading. The DWI parameters, including standard ADC, pure molecular diffusion coefficient (D), perfusion-related diffusion coefficient (D*) and perfusion fraction (f), were compared between two groups using nonparametric test (Mann-Whitney U), and the ROC analysis was used to evaluated the predictive efficiency of DWI parameters in preoperative grading. Results Twelve cases of low grade group and 17 cases of high grade group were confirmed by pathology. The Standard ADC, D, D* and f in low grade group was (1.29±0.27)×10-3 mm2/s, (1.21±0.36)×10-3 mm2/s, (40.20±7.79)×10-3 mm2/s, (23.97±9.22)%, and in high grade group, it was (0.90±0.25)×10-3 mm2/s, (0.75±0.20)×10-3 mm2/s, (53.40±11.99)×10-3 mm2/s, (32.24±12.66)%, respectively. Significant inter-group difference was observed in Standard ADC, D, and D* (all P <0.05). There was no significant difference in f between the two groups. The area under the curve (AUC) of Standard ADC, D, D* in the differential diagnosis of low grade HCC and high grade HCC were 0.86, 0.89, 0.83, and the cut-off value of D was 0.87 × 10-3 mm2/s, the sensitivity and specificity was 90.0% and 80.0%, respectively. Conclusion The IVIM DWI is suitable for the preoperative grading of HCC. |
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