ADC与R2*值对小肝癌病理分级的预测价值及其相关性分析

The Predictive Value and Correlation Analysis of ADC and R2* Value in the Pathological Grading of Small Hepatocellular Carcinoma

目的探讨小肝癌（SHCC）表观扩散系数（ADC）值、横向弛豫率（R2^＊）值与病理等级间的相关性以及SHCC ADC值与R2^＊值之间的相关性。方法搜集33例拟诊SHCC（36枚病灶,最大直径≤2.0 cm）后经病理确诊的患者,行肝脏扩散加权成像（DWI）及R2^＊成像,分别测量病灶内的ADC值及R2^＊值,比较不同病理等级间SHCC的ADC值和R2^＊值的差异,分别探讨ADC值、R2^＊值与SHCC病理等级间的相关性以及SHCC的ADC值和R2^＊值之间的相关性。结果不同级别SHCC组间及组内ADC值差异均有统计学意义（P〈0.05）,ADC值与病理分化等级间呈高度正相关（r=0.887,P=0.000）。不同级别SHCC组间R2^＊值差异有统计学意义（P=0.005）,组内两两比较除中分化与中低分化、中低分化与低分化间差异无统计学意义（P值分别为0.232、0.641）外,其余各组间差异均有统计学意义（P〈0.05）,R2^＊值与病理分化等级间呈中度负相关（r=-0.677,P=0.000）。SHCC ADC值与R2^＊值间呈中度负相关（r=-0.663,P=0.000）。结论 ADC值及R2^＊值有助于预测SHCC的病理分化程度,对手术及治疗方案的选择具有一定的指导作用。

Objective To investigate the correlation between apparent diffusion coefficient（ ADC） values and pathological grade,R2^＊ values and pathological grade and ADC values and R2^＊ values of small hepatocellular carcinoma（ SHCC）.Methods 33 cases suspected of SHCC（ 36 lesions,maximum diameter≤2. 0 cm） then confirmed by pathology underwent diffusion weighted imaging（ DWI） and R2^＊ imaging. ADC values and R2^＊ values of the lesions were measured respectively. The differences of ADC values and R2^＊ values of SHCC between different pathological grades were compared. The correlations between ADC values,R2^＊ values and pathological grades of SHCC and the correlation between ADC values and R2^＊ values of SHCC were investigated. Results There were statistically significant differences of ADC values between or within different pathological grades of SHCC（ P 0. 05）. ADC values had highly positive correlation with the pathological grades（ r = 0. 887,P = 0. 000）. There were statistically significant differences of R2^＊ values between different pathological grades of SHCC（ P = 0. 005）. Other than no statistically significant differences of R2^＊ values between moderately differentiated and moderately-poorly differentiated SHCC,moderately-poorly differentiated and poorly differentiated SHCC（ The P values were 0. 232 and 0. 641 respectively）,there were statistically significant differences within other pathological grades（ P 0. 05）. R2^＊ values had moderate negative correlation with the pathological grades（ r =-0. 677,P = 0. 000）. ADC values had moderate negative correlation with R2^＊ values of SHCC（ r =-0. 663,P = 0. 000）. Conclusion ADC values and R2^＊ values could help us to predict the degree of histological differentiation of SHCC and provide instructive information for treatment programs.