原发性肝癌的中医分型与MRI影像学表现的相关性研究

Correlation between TCM classification of primary liver cancer and MRI imaging manifestations

目的:探究原发性肝癌的磁共振成像(MRI)的影像学表现和中医分型之间的关系。方法:随机抽取河南省中医院2017年7月至2019年4月收治的64例原发性肝癌患者为研究对象,全部开展MRI检查,分析MRI呈现的肿瘤对周边器官的转移和侵犯、占位征象、血管浸润变化、肿瘤扩散加权成像(DWI)信号变化以及肿瘤的大小和形态,并对患者进行中医分型,分析MRI影像表现和中医分型之间的关系。结果:四种证型(肝肾阴虚型、肝郁脾虚型、气滞血瘀型及湿热蕴结型)肿瘤患者之间的肿瘤长径比较差异有统计学意义(P<0.05);四种证型肿瘤数量比较差异未见统计学意义(P>0.05);四种证型肿瘤的结节型数量与巨块型、弥漫型比较,差异有统计学意义(P<0.05);在气滞血瘀型患者中,结节型、弥漫型与巨块型数量比较,差异有统计学意义(P<0.05);四种中医证型的DWI信号、有无癌栓、侵犯状态比较差异有统计学意义(P<0.05)。结论:针对原发性肝癌疾病,应用MRI影像能够为中医分型提供有效参考,有助于中西医联合诊断的发展。

Objective To explore the relationship between magnetic resonance imaging(MRI)manifestations and traditional Chinese medicine(TCM)classification of primary liver cancer.Methods Sixty-four patients with primary liver cancer admitted to Henan Hospital of Traditional Chinese Medicine from July 2017 to April 2019 were randomly selected for the study,and all of them were examined with MRI.The metastasis and invasion of tumor to peripheral organs,space occupying sign,vascular infiltration change,diffusion weighted imaging(DWI)signal change and tumor size and shape on MRI were analyzed,and the patients were classified by TCM,and the relationship between MRI image and TCM classification was analyzed.Results There were significant differences in tumor size among the four types of tumor(hepatic and kidney yin type,liver depression spleen virtual type,gas hysteresis type and wet hot complex type,P<0.05);there was no significant difference in the number of four types of tumor(P>0.05),but there was significant difference in the number of nodular type,bulky type and diffuse type(P<0.05);in patients with gashyl hemorrhoid type,the difference was statistically significant compared with the number of nodule,diffuse ming and giant block type(P<0.05);four types of TCM-licensed DWI signal,cancer-free,and difference in aggressive status are statistically significant(P<0.05).Conclusions In view of the primary liver cancer,the application of MRI can provide an effective reference for the classification of TCM,and contribute to the development of integrated diagnosis of traditional Chinese and Western medicine.