放射学实践2024，Vol.39Issue(12) ：1643-1648.DOI:10.13609/j.cnki.1000-0313.2024.12.015

磁共振虚拟弹性成像在粗梁-团块型肝细胞肝癌术前评估的初步应用

Preliminary study of magnetic resonance virtual elastography in preoperative assessment of macrotrabecu-lar massive hepatocellular carcinoma

王文剑 杨鑫 杭嘉乐 孙骏 傅剑雄 叶靖 罗先富
放射学实践2024，Vol.39Issue(12) ：1643-1648.DOI:10.13609/j.cnki.1000-0313.2024.12.015
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  • 维普
  • 万方数据

磁共振虚拟弹性成像在粗梁-团块型肝细胞肝癌术前评估的初步应用

Preliminary study of magnetic resonance virtual elastography in preoperative assessment of macrotrabecu-lar massive hepatocellular carcinoma

王文剑 1杨鑫 1杭嘉乐 1孙骏 1傅剑雄 1叶靖 1罗先富1
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作者信息

  • 1. 225001 江苏扬州,苏北人民医院(扬州大学附属苏北人民医院)放射科
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摘要

目的:探讨基于DWI的虚拟磁共振弹性成像(vMRE)对粗梁-团块型肝细胞肝癌(MTM-HCC)的术前预测价值.方法:对2022年10月-2024年1月在本院经病理证实的59例HCC患者进行上腹部 MRI扫描,扫描序列包括vMRE、DWI及增强扫描.其中,MTM-HCC组16例,非 MTM-HCC组43例.采用t检验或Mann-Whitney U检验分析两组间虚拟剪切模量(μdiff)、移位表观扩散系数(sADC)、ADC值、临床资料及影像特征的差异,并采用ROC曲线评价各参数预测MTM-HCC的诊断效能.结果:MTM-HCC组的平均虚拟剪切模量(μdiff)值显著高于nMTM-HCC组[(4.96±1.08)vs.(3.31±0.99)kPa,P＜0.001],移位表观扩散系数(sADC)值和ADC值均显著低于nMTM-HCC组[(0.71±0.08)×10-3 vs.(0.84±0.08)× 10-3 mm2/s,P＜0.001;(0.94±0.12)×10-3 vs.(1.04±0.14)×10-3mm2/s,P=0.008].MTM-HCC组和nMTM-HCC组间典型强化及门静脉癌栓出现率的差异有统计学意义(31.2％vs.60.5％,P=0.046;37.5％vs.11.6％,P=0.023).μdiff、sADC、ADC、典型强化及门静脉癌栓预测 MTM-HCC的AUC分别为0.882、0.875、0.722、0.646和0.629,Delong检验示μdiff和sADC的AUC显著高于ADC、门静脉癌栓和典型强化,差异均有统计学意义(P＜0.05).结论:相较于传统影像特征及ADC值,vMRE定量参数μdiff在术前预测MTM-HCC方面具有更高的价值.

Abstract

Objective:To investigate the diagnostic value of virtual magnetic resonance elastogra-phy(vMRE)based on diffusion weighted imaging in macrotrabecular massive hepatocellular carcino-ma(MTM-HCC).Methods:From October 2022 to January 2024,the upper abdominal MRI scans were performed in 89 patients with hepatocellular carcinoma confirmed by pathology,including vMRE,DWI and enhanced MRI.There were 16 cases in the MTM-HCC group and 43 cases in the nMTM-HCC group.Mann-Whitney U-test or t-test was used to analyze the differences in values of average virtual shear modulus(μdiff),shifted apparent diffusion coefficient(sADC)and ADC,clinical data and imaging features between two groups,and receiver operating characteristic(ROC)curve was used to evaluate the diagnostic efficacy of each parameter in predicting MTM-HCC.Results:A total of 59 HCC patients were enrolled in this study.The values of μdiff in MTM-HCC group was higher than that of the nMTM-HCC group[(4.96±1.058)vs.(3.31±0.989)kPa,P＜0.001];the values of sADC was lower than that of nMTM-HCC group[(0.71±0.08)× 10-3 vs.(0.84±0.08)× 10-3 mm2/s,P＜0.001],and ADC was lower than that of nMTM-HCC group[(0.94±0.12)× 10-3 vs.(1.04±0.14)× 10-3 mm2/s,P=0.008].The proportions of typical enhancement and portal vein tumor thrombus between MTM-HCC group and nMTM-HCC group were statistically significant(31.2％vs.60.5％,P=0.046;37.5％vs.11.6％,P=0.023).The AUC values of μdiff,sADC,ADC,typical enhancement and portal vein tumor thrombus to predict MTM-HCC were 0.882,0.875,0.722,0.646 and 0.629.Delong test showed that the diagnostic efficacy of μdiff was and sADC significantly higher than that of ADC,portal vein tumor thrombus and typical enhancement(all P＜0.05).Conclusion:Compared with traditional imaging fea-tures and ADC,the quantitative parameter μdiff of vMRE has a higher diagnostic value in preoperative prediction of MTM-HCC.

关键词

肝肿瘤/粗梁-团块型/虚拟弹性成像/扩散加权成像

Key words

Hepatocellular carcinoma/Macrotrabecular-massive/Virtual magnetic resonance elastography/Diffusion-weighted imaging

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出版年

2024
放射学实践
华中科技大学同济医学院

放射学实践

CSTPCD北大核心
影响因子：1.08
ISSN：1000-0313
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