术前扩散加权成像指导肝癌临床诊治的可行性研究

Feasibility study of preoperative diffusion-weighted imaging in guiding clinical diagnosis and treatment of liver cancer

目的探讨术前扩散加权成像(DWI)指导肝癌临床诊治的可行性。方法选取82例肝癌患者,均给予DWI检查,检测肿瘤实性部分的平均表观扩散系数(ADC)和最小ADC。分析不同分化程度、微血管侵犯(MVI)情况肝癌患者的ADC值。结果82例肝癌患者中,高分化13例,中分化56例,低分化13例。高分化肝癌患者平均ADC值、最小ADC值均明显高于中分化、低分化患者(P﹤0.01),中分化肝癌患者的平均ADC值、最小ADC值均明显高于低分化患者(P﹤0.01)。82例肝癌患者中,MVI阳性35例,阴性47例。MVI阳性肝癌患者的平均ADC值、最小ADC值均明显低于MVI阴性患者(P﹤0.01)。结论术前DWI检查可有效预测肝癌分化程度及MVI,ADC值可初步评估肿瘤患者的MVI及分化程度,可帮助医师选择更合适的治疗方案,以改善患者的预后。

Objective To investigate the feasibility of preoperative diffusion-weighted imaging(DWI)in guiding the clinical diagnosis and treatment of liver cancer.Method The clinical data of 82 liver cancer patients underwent DWI was collected.The average apparent diffusion coefficient(ADC)value and the minimum ADC value of the solid part of the tumor were measured.The ADC values of patients with different differentiation degree and microvascular invasion(MVI)were analyzed.Result There were 13 cases of high differentiation,56 cases of medium differentiation and 13 cases of poor differentiation in 82 cases.The average and minimum ADC values of the high differentiation group were higher than those of the medium and poor differentiation groups(P<0.01),and medium differentiation group higher than those of poor differentiation group(P<0.01).There were 35 cases of positive MVI and 47 cases of negative MVI.The average and minimum ADC values of the MVI-positive group were significantly lower than those of the MVI-negative group(P<0.01).Conclusion Preoperative DWI examination can effectively predict the degree of differentiation and MVI of liver cancer,and the ADC value can preliminarily evaluate the MVI and degree of differentiation of tumor patients,which can help physicians choose a more appropriate treatment plan to improve the prognosis of patients.