常规MRI联合DWI对不同分化程度小肝癌的诊断价值

The Diagnosis Value of MRI Combined with DWI in Different Degree of Differentiation Small Hepatocellular Carcinoma

目的研究常规磁共振成像(MRI)和磁共振弥散加权成像(DWI)对不同分化程度小肝癌(sHCC)的诊断价值;方法将sHCC患者根据病理分化程度分为4组,患者均行腹部常规MRI和DWI。并对不同组别患者的ADC值进行统计分析;结果 34例小肝癌患者中,T1W1稍低/低信号、等信号、稍高/高信号分别为27例、4例、3例;T2W1除1例等信号外,33例均为稍高/高信号;血供方面,多血供与少血供分别为28例与6例;延迟期与临近肝实质信号比较,高信号、等信号、低信号例数分别为4例、10例、20例;23例伴有包膜形成;DWI31例高信号,3例等信号;高分化组、高中分化组、中分化组、中低分化组瘤灶的ADC值分别为(1.79±0.31)×10-3、(1.89±0.68)×10-3、(1.82±0.52)×10-3、(1.70±0.19)×10-3。4组比较,差异无统计学意义(t=1.723,P=0.608);常规MRI联合DWI的AUC(0.902)高于常规MRI(0.800);结论 MRI联合DWI对早期sHCC的诊断价值较高,尤其是不典型sHCC。

Objective To study the diagnosis value of normal magnetic resonance imaging （ MRI ） and diffusion weighted magnetic resonance imaging （ DWI ） on the differentiation of small hepatocellular carcinoma （ sHCC ）. Methods The sHCC were divided into 4 groups according to the degree of differentiation pathology, the patients underwent routine ab- dominal MRI and DWI. And ADC value of patients in different groups werestatistical analysised. Results 34 patients with sHCC, T1WI hypointensity（27）, isointensisty （4）, hyperintensity （3）;T2Wl except 1 cases isointensisty, 33 cases were hyperintensity; more blood with less blood supply 28cases and 6 cases respectively： Delay compared with near the liver parenchyma signal, high signal, such as signal and low signal cases of 4 cases, 10 cases, 20 cases respectively： 33 patients with pseudocapsule; DWl 31 cases of hyperintensity, 3 cases of isointensisty ; The ADC values of tumors in high differentiation group, high and middle differentiation group, middle differentiation group, low differentiated were（1.79±0.31）×10^-3、（1.89±0.68）×10^-3、（1.82±0.52）×10^-3、（1.70±0.19）×10^-3, 4 groups were coapared, no significant difference （ t=1.723, P=0.608 ）： The AUC of conventional MRI combined with DWI （ 0.902 ） was higher than conventional MRI （0.800）. Conclusion MRI combined with DW1 have higher diagnostic value for early sHCC, especially atypical sHCC.