扩散峰度成像技术对肝癌患者癌细胞周围浸润的评估价值

Evaluation of diffusion kurtosis imaging in diagnosing peritumoral infiltration in patients with hepatocellular carcinoma

目的探讨扩散峰度成像(DKI)在肝癌周围浸润中的评估价值。方法纳入我院2017年10月—2019年10月收治的肝癌患者56例作为肝癌组,选取同期收治的健康体检者56例作为对照组,均行DKI扫描,其中肝癌组分别行肝癌组织、癌周肝实质、远癌肝实质检查,作为肝癌A组、肝癌B组、肝癌C组。比较四组DKI参数,根据临床综合诊断结果,将肝癌患者分成周围浸润组(41例)、无周围浸润组(15例),分析DKI参数对肝癌周围浸润的评估价值。结果肝癌A组、B组、C组的MD、Dr、Da显著低于对照组,且FA、Ka、FAk显著高于对照组(P<0.05)。肝癌A组的MD、Dr、Da显著低于肝癌B组、C组,且肝癌A组的FA显著低于肝癌B组(P<0.05)。周围浸润组MD、Dr、Da显著低于无周围浸润组,Ka显著高于无周围浸润组(P<0.05)。MD、Dr、Da、Ka评价肝癌周围浸润的AUC分别为0.749、0.733、0.720、0.685。结论DKI技术对肝癌周围浸润的评估有较高价值,其中MD、Dr、Da、Ka可作为评价肝癌患者是否存在周围浸润的重点观察项目。

Objective To evaluate the value of diffusion kurtosis imaging(DKI)in diagnosing the peritumoral infiltration of hepatocellular carcinoma.Methods Fifty-six cases of liver cancer patients admitted to our hospital from October 2017 to October 2019 were included as the liver cancer group,and 56 cases of healthy physical examination persons admitted during the same period were selected as control group.All of the them received DKI scanning.Liver cancer tissue,peritumoral liver parenchyma and distant liver parenchyma were examined in the liver cancer group,respectively,as group A,B and C.DKI parameters of the 4 groups were recorded.According to the clinical comprehensive diagnosis,patients with liver cancer were divided into peritumoral infiltration group(41 cases)and non-peritumoral infiltration group(15 cases).The value of DKI parameters in diagnosing the peritumoral infiltration of liver cancer was analyzed.Results The mean diffusivity(MD),radial diffusivity(Dr)and axial diffusivity(Da)of group A,B and C were significantly lower than those of control group,and fractional anisotropy(FA),axial kurtosis(Ka)and fractional anisotropy of kurtosis(FAk)were significantly higher than those of control group(P<0.05).The MD,Dr and Da of group A were significantly lower than those of group B and group C,and the FA of group A was significantly lower than that of group B(P<0.05).MD,Dr And Da in peritumoral infiltration group were significantly lower than those in non-peritumoral infiltration group,and Ka was significantly higher than that in non-peritumoral infiltration group(P<0.05).The area under the receiver operating characteristic curve of MD,Dr,Da and Ka were 0.749,0.733,0.720 and 0.685,respectively.Conclusion DKI has high value in diagnosing the peritumoral infiltration of liver cancer.MD,Dr,Da and Ka can be used as the focused parameters to diagnose peritumoral infiltration in liver cancer patients.