基于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分析

发布时间：2019-04-19 03:45

【摘要】：目的探讨基于体素内不相干运动(IVIM)扩散加权成像(DWI)在肝细胞癌(HCC)术前分级中的可行性。方法回顾性分析35例HCC患者的影像学及病理资料。以Edmondson-Steiner分级法为依据分为低、高级别组,应用双指数函数分别计算两组的真实扩散系数(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,3个参数间的预测效能比较用受试者工作特征曲线(ROC)分析,当P0.05认为差异有统计学意义。结果低级别组15例,高级别组20例。低级别组D、D*及f值的均值分别为(1.20±0.32)×10-3mm2/s、(42.57±11.07)×10-3mm2/s、(23.19±10.02)%,高级别组D、D*及f值的均值分别为(0.76±0.18)×10-3mm2/s、(53.89±12.74)×10-3mm2/s、(30.07±12.42)%,与高级别组的HCC相比较,低级别组的D值增大,D*值减小,组间均存在统计学差异(U=22.5、62.0,P0.05);f值减小,组间不存在统计学差异(U=82.0,P0.05)。D值、D*值的ROC曲线下面积(AUC)为0.92、0.77,根据最大约登指数确定两者的最佳诊断阈值分别为0.91×10-3mm2/s、53.1×10-3mm2/s。结论 IVIM DWI对术前预测HCC的低、高级别有一定帮助,其中D值的诊断效能最大。
[Abstract]:Objective to investigate the feasibility of intravoxel incoherent motion (IVIM) diffusion weighted imaging (DWI) in the preoperative grading of hepatocellular carcinoma (HCC) with (HCC). Methods the imaging and pathological data of 35 patients with HCC were retrospectively analyzed. According to the Edmondson-Steiner classification method, low and high grade groups were divided into two groups. The real diffusion coefficient (D value), perfusion correlation diffusion coefficient (D * value) and perfusion fraction (f value) of the two groups were calculated by using the double exponential function. Non-parametric test Mann-Whitney-U was used to compare the predictive efficacy of the three parameters, and (ROC) was used to analyze the predictive efficacy of the three parameters. The difference was statistically significant when P0.05 was considered to be significant. Results there were 15 cases in low grade group and 20 cases in high grade group. The mean values of D, D * and f in low-grade group were (1.20 卤0.32) 脳 10 脳 10 ~ (3) mm ~ (2), (42.57 卤11.07) 脳 10 ~ (3) mm ~ 2, (23.19 卤10.02)% and (23.19 卤10.02)% in high-grade group, respectively. The mean values of D ~ * and f were (0.76 卤0.18) 脳 10 脳 10 ~ (3) mm ~ (2 / s), (53.89 卤12.74) 脳 10 脳 10 ~ (3) mm ~ (2) and (30.07 卤12.42)%, respectively. Compared with high-grade group, the D-value of low-grade group increased and D * value decreased, compared with that of high-grade group, HCC of low-grade group increased and D * value decreased. There were statistical differences between the two groups (U = 22.5, 62.0, P0.05); The area (AUC) under the ROC curve of D value and D * value was 0.92, 0.77, respectively, and there was no statistical difference between the two groups (U = 82.0, P0.05). The optimal diagnostic thresholds are 0.91 脳 10 ~ (- 3) mm ~ (2 / s), 53.1 脳 10 ~ (- 3) mm ~ (2 / s) and 53.1 脳 10 ~ (- 3) mm ~ (2) respectively. Conclusion IVIM DWI is helpful to predict the low and high grade of HCC before operation, among which D value is the most effective.
【作者单位】：郑州大学第一附属医院磁共振科;
【分类号】：R735.7;R445.2

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