肝脏良恶性病变磁共振动态增强扫描定量参数的测定及其临床价值

The quantitative parameters of dynamic contrast-enhanced magnetic resonance imaging of hepatic benign and malignant lesions and their clinical value

目的:测定肝脏良恶性病变磁共振(MRI)动态增强扫描定量参数水平并探讨其对病情的评估价值。方法:67例原发性肝癌患者、78例肝脏良性病变患者分别作为肝癌组、肝脏良性病变组。检测两组患者的术前MRI动态增强扫描定量参数水平,评估具体参数水平与肝癌相关增殖、侵袭基因表达量的相关关系。结果:肝癌组平均强化时间(MET)、最大上升斜率(MSI)的水平低于肝脏良性病变组,最大下降斜率(MSD)的水平高于肝脏良性病变组。肝癌组病灶组织中增殖基因PRMT5、CDCA5、SIRT2、XIAP、Cep55mRNA的表达量均高于肝脏良性病变组;侵袭基因Cripto-1、IFITM3mRNA的表达量高于肝脏良性病变组,KLF4、HOXA9mRNA的表达量低于肝脏良性病变组。Pearson检验发现,肝癌组织MRI动态增强扫描定量参数MET、MSI、MSD的水平与癌细胞增殖、侵袭活性均直接相关。结论:肝癌MRI动态增强扫描定量参数MET、MSI、MSD水平存在明显异常,且具体水平可客观反映肿瘤恶性程度。

Objective:To determine the quantitative parameter levels of dynamic contrast-enhanced magnetic resonance imaging(MRI)of hepatic benign and malignant lesions and to explore their value for the evaluation of the disease.Methods:67 patients with primary liver cancer and 78 patients with hepatic benign lesion were selected as the liver cancer group and hepatic benign lesion group respectively.The preoperative quantitative parameter levels of dynamic contrast-enhanced MRI of the two groups were measured,and the correlation of the specific parameter levels with liver cancer-related proliferation and invasion gene expression was evaluated.Results:The mean time to enhance(MET)and maximum slope of increase(MSI)levels of the liver cancer group were lower than those of the hepatic benign lesion group while the maximum slope of decrease(MSD)level was higher than that of the hepatic benign lesion group.Proliferation genes PRMT5,CDCA5,SIRT2,XIAP and Cep55 mRNA expression in the lesion tissues of the liver cancer group were all higher than those of the hepatic benign lesion group;invasion genes Cripto-1 and IFITM3 mRNA expression were higher than those of the hepatic benign lesion group while KLF4 and HOXA9 mRNA expression were lower than those of the hepatic benign lesion group.Pearson test showed that the quantitative parameters MET,MSI and MSD levels of dynamic contrast-enhanced MRI in liver cancer tissues were directly correlated with the proliferation and invasion activity of cancer cells.Conclusion:The quantitative parameters MET,MSI and MSD levels of dynamic contrast-enhanced MRI of liver cancer are significantly abnormal,and the specific levels could objectively reflect the tumor malignancy.