Contrast-enhanced MRI and IVIM-DWI in the diagnosis of patients with small hepatocellular carcinoma
Objective The aim of this study was to explore the diagnostic performance of contrast-enhanced magnetic resonance imaging(MRI)and intravoxel incoherent motion-diffusion weighted imaging(IVIM-DWI)in patients with small hepatocellular carcinoma(sHCC).Methods 73 patients with focal nodular hyperplasia(FNH)were enrolled in our hospital between May 2020 and May 2023,and all patients underwent contrast-enhanced MRI and IVIM-DWI,recording the pseudo diffusion coefficient(D∗),true diffusion coefficient(D)and perfusion fraction(f).The fine needle aspiration biopsies or postoperative histopathology were performed for golden diagnosis.The diagnostic efficacy of contrast-enhanced MRI and IVIM-DWI was evaluated by receiver operating characteristic(ROC)curves.Results Among the 73 patients with FNH,the histopathology examination showed sHCC in49 cases(67.1%)and the dysplastic nodules(DN)in 24 cases(32.9%);the percentages of low signals on T1WI,high signals on T2WI,arterial phase enhancement and low signals during hepatobiliary phase in HCC lesions were 61.2%,83.7%,59.2%and 89.8%,all significantly higher than 20.8%,33.3%,25.0%and 29.2%(P<0.05)in DN lesions;the D∗ and D in HCC lesions were(50.9±11.6)×10-3mm2/s and(0.8±0.2)×10-3mm2/s,both significantly less than[(78.4±15.8)×10-3mm2/s and(1.2±0.3)×10-3mm2/s,P<0.05]in DN lesions,while there was no significant difference as respect to f between the two lesions[(45.6±8.7)%vs.(43.9±9.5)%,P>0.5];the ROC analysis showed the AUC was 0.968,with the sensitivity of 100.0%and the specificity of 86.0%,when the T1WI and T2WI signals,arterial phase enhancement,hepatobiliary phase signal,D∗ and D was combined for the diagnosis of sHCC.Conclusion The contrast-enhanced MRI and IVIM-DWI are efficacious in the diagnosis of patients with sHCC,which might provide the clinicians a reliably tool for early differentiation of patients with FNH.
HepatomaDysplastic nodulesContrast-enhanced magnetic resonance imagingIntravoxel incoherent motion-diffusion weighted imagingDiagnosis
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