小肝癌MR信号特征与病理组织分型相关性分析

Correlation analysis between MR signal features and histopathological type in small hepatocellular carcinoma

目的分析小肝癌MR信号特征与病理组织分型的相关性。方法在2009年10月至2017年12月北京解放军第三○二医院手术切除小肝癌且于手术前1个月内进行MR动态增强扫描检查的病例中,选取病理组织分型为单一型的病例21例。病理组织分型按WHO肝癌病理分类标准分为3组:假腺型、致密型和梁索型。测量并计算MR T1WI、T2WI、DWI序列及动态增强扫描动脉期、门脉期、延迟期病变信号值与相邻肝背景信号值的比值,进行统计学分析。结果21例患者共有21个病灶,其中假腺型10例、致密型5例、梁索型6例。假腺型和致密型T2WI信号值差异有统计学意义(P<0.01),致密型和梁索型T2WI信号值差异有统计学意义(P<0.05),假腺型和致密型T1WI信号值差异有统计学意义(P<0.05),而DWI序列和动态增强扫描各期病变信号值与病理组织类型之间差异无统计学意义。结论小肝癌MR T1WI、T2WI信号值与病理组织分型相关。

Objective To investigate the correlation between magnetic resonance(MR)signal characteristics and histopathological classification of small hepatocellular carcinoma(HCC).Methods Twenty-one patients with single histopathological type were enrolled in the study,who were diagnosed of small HCC in our hospital from October 2009 to December 2017.Dynamic contrast-enhanced MR scan was performed in all cases within 1 month before operation.Patients were classified into 3 groups according to world health organization(WHO)pathological classification criteria,including pseudoglandular type(n=10),compact type(n=5)and trabecular type(n=6).Ratio of lesion signal value to adjacent liver background signal value was calculated and analyzed in T1 weighted imaginge(T1WI),T2 weighted imaginge(T2WI)and diffusion weighted imaging(DWI)and dynamic contrast-enhanced MR scan during arterial phase,portal phase and delayed phase,respectively.Results T2WI signal value in compact type was significantly different from that in pseudoglandular type(P<0.01)and trabecular type(P<0.05).T1WI signal value showed significant differences between pseudoglandular type and compact type(P<0.05).However,there was no significant difference in DWI sequence and dynamic contrast-enhanced scan among different histopathological types.Conclusion The signal values of MR T1WI and T2WI in small HCC are correlated with histopathological types.