Gd-EOB-DTPA增强MRI征象与ADC值预测孤立性肝细胞癌微血管侵犯的价值

A study on the application of Gd-EOB-DTPA enhanced MRI and ADC values in predicting microvascular invasion in isolated hepatocellular carcinoma

目的应用MRI表观扩散系数及钆塞酸二钠(Gd-EOB-DTPA)增强的影像特点,预测孤立性肝细胞癌(HCC)微血管侵犯(MVI)。方法收集2017年03月~2020年01月联勤保障部队第九〇〇医院经病理确诊为HCC手术前行Gd-EOB-DTPA增强MRI扫描的86例患者影像学资料。记录影像学资料包括肝胆期瘤周低信号、动脉期瘤周强化、肿瘤直径、有无脂肪变性、肿瘤假包膜、肿瘤相对强化率、肿瘤边缘、ADC的平均值及最小值,采用Pearson's卡方检验、独立样本t检验、Mann–Whitney U检验进行统计学分析,并进一步采用受试者工作特征曲线(ROC)分析各指标评价MVI的诊断性能。结果肝胆期肿瘤周围低信号、肝胆期肿瘤边缘不规则、肿瘤直径≥3.8 cm、平均ADC值、最小ADC值等指标在MVI阳性组与阴性组间差异有统计学意义(P<0.05),ROC曲线下面积分别为0.827、0.721、0.725、0.747、0.772。结论ADC值及Gd-EOB-DTPA增强磁共振的部分影像表现可以预测孤立性肝细胞癌MVI。

Objective To study the application of the apparent diffusion coefficient of MRI and the enhanced imaging features of Gd-EOB-DTPA in predicting the microvascular invasion of solitary hepatocellular carcinoma(HCC).Methods The preoperative MRI data of 86 patients with hepatocellular carcinoma confirmed by pathology were collected.The image features,including hepatobiliary phase peritumoral low signal intensity,arterial peritumoral enhancement,tumor diameter,steatosis,tumor pseudocapsule,tumor relative enhancement rate,tumor margin,mean and minimum value of ADC,were recorded and statistically analyzed using Pearson’s chi-square test,independent sample t-test and Mann-Whitney U test.Then the diagnostic performance of microvascular invasion was evaluated by(ROC)analysis of the receiver working characteristic curve.Results Low signal intensity around hepatobiliary tumor,irregular margin of hepatobiliary tumor,tumor diameter equal to or greater than 3.8 cm,average ADC value and minimum ADC value were significantly different between the two groups with and without MVI(P<0.05).Area under the ROC curve were 0.827,0.721,0.725,0.747 and 0.772,respectively.Conclusions ADC value and some imaging findings of gadolinium sesame acid disodium enhanced magnetic resonance imaging can predict microvascular invasion in solitary hepatocellular carcinoma.