目的 分析增强磁共振成像(MRI)多模态参数与原发性肝癌患者肝功能分级的相关性.方法 选择2020年9月-2023年9月在延安大学附属医院进行治疗的70例原发性肝癌患者作为研究对象,依据Child-Pugh分级将其分为A级(n=21)、B级(n=36)、C级(n=13).比较增强MRI与手术病理分级的一致性、不同肝功能分级患者的增强MRI多模态参数,采用Spearman秩相关分析增强MRI多模态参数与原发性肝癌患者肝功能分级的相关性.结果 经一致性分析证实,增强MRI与手术病理分级的准确率91.43％、灵敏度90.48％、特异度92.86％、阳性预测值95.00％、阴性预测值 92.86％、Kappa 值=0.824;肝功能 A 级患者的 T1、D*及 f 值[(503.49±40.32)ms、(61.35±5.89)× 10-3 mm2/s、(28.65±3.27)％]均低于肝功能 B 级患者[(545.67±45.39)ms、(65.87±6.36)× 10-3 mm2/s、(33.26±3.82)％],T2,ADC 及 D 值[(73.56±6.82)ms、(1.67±0.32)× 10-3 mm2/s、(1.47±0.19)× 10-33 mm2/s]高于肝功能 B 级患者[(65.43±5.89)ms、(1.41±0.26)× 10-3 mm2/s、(1.28±0.16)× 10-3 mm2/s],肝功能 B 级患者的 T1、D*及 f 值均低于肝功能 C级患者[(575.52±56.31)ms、(71.33±6.52)× 10-3 mm2/s、(36.13±4.36)％],T2,ADC 及 D 值高于肝功能 C 级患者[(61.26±5.37)ms、(1.24±0.19)× 10-3 mm2/s、(1.06±0.13)× 10-3 mm2/s](P＜0.05);相关性分析显示,T1、D*及 f值与原发性肝癌患者肝功能分级呈正相关(r=0.535、0.432、0.519,P＜0.05),T2、ADC及D值与原发性肝癌患者肝功能分级呈负相关(r=-0.426、-0.597、-0.524,P＜0.05).结论 增强磁共振成像(MRI)多模态参数可有效判断原发性肝癌患者肝功能损害程度,临床诊治时可结合以上结果制定针对性治疗方案.
Correlation analysis of enhanced MRI multimodal parameters and liver function grading in patients with primary liver cancer
Objective To analyze the correlation between multimodal parameters of enhanced magnetic resonance imaging(MRI)and liver function grading in patients with primary liver cancer.Methods Seventy patients with primary liver cancer treated at the hospital from September 2020 to September 2023 were enrolled,and were divided into grade A(n=21),grade B(n=36)and grade C(n=13)according to Child-Pugh classification.Spearman rank correlation analysis was used to compare the consistency of enhanced MRI with surgical pathological grade and the correlation of enhanced MRI multimodal parameters with liver function grade in patients with primary liver cancer.Results Consistency analysis showed that the accuracy,sensitivity,specificity,positive predictive value,negative predictive value and Kappa value were 91.43％,90.48％,92.86％,95.00％,92.86％,0.824,respectively.The T1,D*and f values[(503.49±40.32)ms,(61.35±5.89)× 10-3 mm2/s,(28.65±3.27)％]of patients with liver function grade A were lower than those of patients with liver function grade B[(545.67±45.39)ms,(65.87±6.36)× 10-3 mm2/s,(33.26±3.82)％].T2,ADC and D values[(73.56±6.82)ms,(1.67±0.32)× 10-3 mm2/s,(1.47±0.19)×10-3 mm2/s]were higher than those with grade B liver function[(65.43±5.89)ms,(1.41±0.26)× 10-3 mm2/s,(1.2 8±0.16)×10-3mm2/s].T1,D* and f values of patients with liver function grade B were lower than those of patients with grade C liver function[(575.52±56.31)ms,(71.33±6.52)× 10-3 mm2/s,(36.13±4.36)％].T2,ADC and D values were significantly higher than those with grade C liver function[(61.26±5.37)ms,(1.24±0.19)×10-3mm2/s,(1.06±0.13)× 10-3 mm2/s](P＜0.05).Correlation analysis showed that T1,D*and f values were positively correlated with liver function grade in patients with primary liver cancer(r=0.535,0.432,0.519,P＜0.05),while T2,ADC and D values were negatively correlated with liver function grade(r=-0.426,-0.597,-0.524,P＜0.05).Conclusion Enhanced magnetic resonance imaging(MRI)multimodal parameters can effectively modify the degree of liver function in patients with primary liver cancer,and can be combined with the above results in clinical diagnosis and treatment plan.
Multimodal parameters of enhanced magnetic resonance imagingPrimary liver cancerLiver function classificationCorrelation
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