扩散加权成像定量指标在小肝细胞癌组织学分级中的应用

The Application of Quantitative Indicators Based on Diffusion Weighted Imaging in Histological Grading of Small Hepatocellular Carcinoma

目的评价扩散加权成像(DWI)的定量指标在小肝细胞癌(SHCC)组织学分级中的应用价值。方法回顾性分析139例病理证实为SHCC的病例资料,分为高、中、低分化组。分析b值为800 s/mm2的DWI定量指标信号强度(SI)值及最小表观扩散系数(ADCmin)值在预测SHCC组织学分级中的应用。结果SI值与SHCC组织学分级呈正相关(r=0.300,P<0.05),高、中、低分化SHCC的SI值分别为26.261±12.990、32.073±16.264、40.895±24.689,三组间SI值有统计学意义(F=6.854,P<0.05),且SI值在高和低分化组间有统计学意义,但在其他组间无统计学意义;ADCmin值与SHCC组织学分级呈负相关(r=-0.445,P<0.05),高、中、低分化SHCC ADCmin值分别为(0.992±0.293)×10^-3mm^2/s、(0.849±0.194)×10^-3mm^2/s、(0.693±0.213)×10^-3mm^2/s,存在差异性(F=16.771,P<0.05),且任意两两比较均有统计学意义。结论DWI的SI值对于SHCC的组织学分级提供的价值有限,ADCmin值可能是非侵入性地预测SHCC组织学分级的有用工具,可为临床提供更好的诊疗依据。

Objective To evaluate the application of quantitative diffusion-weighted imaging(DWI)in predicting the histological grade of small hepatocellular carcinoma(SHCC).Methods 139 patients with pathologically confirmed SHCC were divided into well-differentiated,moderately differentiated,and poorly differentiated groups were evaluated retrospectively.The relationships between signal intensity(SI)and minimum apparent diffusion coefficient(ADCmin)values on DWI,and the histopathological differentiation of SHCC were analysed.Results There was a positive correlation between the SI value on the DWI and the histological grade of SHCC(r=0.300,P<0.05),the SI values of the well-,moderately and poorly differentiated SHCC were 26.261±12.990,32.073±16.264,40.895±24.689,respectively.The SI values of the three groups were statistically significant(F=6.854,P<0.05),and the SI values were statistically significant between the well-and poorly differentiation groups,but there was no statistical significance among the other groups.There was a negative correlation between the minimum ADC value and histological grade of SHCC(r=-0.445,P<0.05).The ADCmin values of well-,moderately,and poorly differentiated SHCC were 0.992±0.293,0.849±0.194,0.693±0.213×10^-3mm^2/s,respectively.There was a statistically significant difference(F=16.771,P<0.05),with significant differences between any two combinations of groups.Conclusion The SI value of DWI provides limited value for the histological grade of SHCC.The ADCmin value may be a useful tool for predicting the histological grade of SHCC non-invasively,and providing a better basis for clinical diagnosis and treatment.