磁共振扩散张量成像鉴别诊断肝内胆管细胞癌与肝细胞癌

发布时间：2018-07-15 08:09

【摘要】：目的探讨磁共振扩散张量成像(DTI)鉴别肝内胆管细胞癌(ICC)和肝细胞癌(HCC)的价值。方法回顾性分析在我院接受肝脏MR检查并经病理证实的ICC 20例(ICC组)、HCC 32例(HCC组)。所有患者均接受1.5T MRI常规T1WI、T2WI、DWI及DTI序列扫描,观察病变影像学特征。由2名观察者独立测量两组病灶DTI的弥散系数(D)值、各向异性分数(FA)值及DWI的ADC值,分析其测量的一致性并进行组间比较。对有统计学差异的参数,绘制ROC曲线,分析诊断效能及阈值。结果 ICC组9例(9/20,45.00%)病灶边界清晰,HCC组15例(15/32,46.88%)边界清晰,差异无统计学意义(χ~2=0.02,P=0.90)。ICC组11例(11/20,55.00%)可见邻近胆管扩张,高于HCC组(4/32,12.50%),差异有统计学意义(χ~2=10.83,P=0.001)。2名观察者测得的2组各参数结果一致性良好,相关系数值均大于0.90。ICC组FA值(0.45±0.16)高于HCC组(0.30±0.13),差异有统计学意义(P=0.001);2组的ADC值和D值差异均无统计学意义(P均0.05)。FA值ROC曲线下面积为0.76,在界值为0.31时,鉴别诊断ICC与HCC的敏感度(85.0%)较高。结论 DTI的FA值对鉴别ICC与HCC有较高的诊断效能,可以为临床提供重要参考。
[Abstract]:Objective to evaluate the value of magnetic resonance diffusion Zhang Liang imaging in differentiating intrahepatic cholangiocarcinoma from hepatocellular carcinoma. Methods 32 cases (HCC group) with ICC 20 cases (ICC group) underwent liver Mr examination in our hospital were retrospectively analyzed. All the patients underwent 1.5T MRI routine T _ 1WI T _ 2WI and DTI sequences to observe the imaging features of the lesions. Diffusion coefficient (D), anisotropy fraction (FA) and ADC value of DWI were measured by two observers. For the parameters with statistical difference, the ROC curve was drawn, and the diagnostic efficacy and threshold were analyzed. Results in ICC group, 9 cases (9 / 205.00%) had clear lesion boundary and 15 cases (15 / 32 / 46.88%) had clear lesion boundary (15 / 32 / 46.88%). There was no significant difference between ICC group and ICC group (蠂 ~ (20.02) P ~ (0.90). In ICC group, 11 cases (11 / 20 ~ 55.00%) showed dilatation of adjacent bile duct. It was higher than that in HCC group (4 / 32, 12.50%), and the difference was statistically significant (蠂 ~ (2 / 2) 10.83 ~ (3) P ~ (0. 001). The correlation coefficient was greater than 0.90.ICC group (0.45 卤0.16) and HCC group (0.30 卤0.13). There was no significant difference in ADC value and D value between two groups (P 0.05). The area under ROC curve of FA value was 0.76. The sensitivity of differentiating ICC and HCC (85.0%) was higher when the threshold value was 0.31. Conclusion the FA value of DTI has high diagnostic efficacy in differentiating ICC from HCC and can provide important reference for clinical practice.
【作者单位】：大连医科大学附属第一医院放射科;北京通用电气医疗集团;
【分类号】：R445.2;R735.7

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