钆塞酸二钠MRI增强成像预测肝细胞癌病理分级及早期复发率的价值分析

Value of Gd-EOB-DTPA-enhanced MRI for prediction of the pathological grade and early recurrence rate of hepatocellular carcinoma

目的:探讨钆塞酸二钠MRI增强成像在预测肝细胞癌(hepatic cell carcinoma,HCC)病理分级及早期复发率中的价值。方法:回顾性分析2016年1月至2017年10月在百色市人民医院接受钆塞酸二钠MRI增强成像检查及手术治疗的HCC患者90例的影像学资料、临床病理资料及随访资料。探讨钆塞酸二钠MRI增强成像在肝胆期不同信号强度与患者术后病理分级的相关性,并通过Kaplan-Mrier生存分析探讨肝胆期病灶的信号特征对患者早期复发率的影响。结果:90例HCC患者中肝胆期呈低信号59例(65.56%),混杂信号31例(34.44%),未见呈高信号患者;肝胆期信号强度与肿瘤病理分级(χ^(2)=2.26,P=0.040)及肿瘤大小(t=3.10,P=0.033)之间差异均有统计学意义;混杂信号患者的早期复发率明显高于低信号患者(χ^(2)=2.25,P=0.041)。结论:钆塞酸二钠MRI增强成像肝胆期不同信号强度在一定程度上有预测HCC病理分级及患者早期复发率的潜能。

Objective:To investigate the value of gadolinium ethoxybenzyl diethylenetriaminepentaacetic acid(Gd-EOB-DTPA)-enhanced MRI in predicting the pathological grade and early recurrence rate of hepatocellular carcinoma.Methods:The imaging data,pathological data,and follow-up data of 90 patients with hepatocellular carcinoma who underwent Gd-EOB-DTPA-enhanced MRI examination and surgical treatment in People's Hospital of Baise from January 2016 to October 2017 were retrospectively analyzed.The correlation between the signal intensity of contrast-enhanced MRI and postoperative pathological grade was analyzed.Kaplan-Meier survival analysis was performed to investigate the effects of the signal characteristics of hepatobiliary lesions on the early recurrence rate of hepatocellular carcinoma.Results:A total of 59(65.56%)patients showed low-intensity signals and 31(34.44%)patients showed mixed-intensity signals.High-intensity signal was not found in any patients.The signal intensity of the hepatobiliary phase was significantly correlated with the pathological grade of the tumor(χ^(2)=2.26,P=0.040)and tumor size(t=3.10,P=0.033).The early recurrence rate of hepatocellular carcinoma was significantly higher in patients exhibiting mixed-intensity signals than that in patients exhibiting low-intensity signals(χ^(2)=2.25,P=0.041).Conclusion:Gd-EOB-DTPA-enhanced MRI in the hepatobiliary phase with different signal intensities has the potential to predict the pathological grade and early recurrence rate of hepatocellular carcinoma.