基于磁共振扩散加权成像相关参数预测肝细胞癌射频消融术后短期侵袭性复发转移的价值分析

The value of magnetic resonance diffusion-weighted imaging related parameters in predicting short-term invasive recurrence and metastasis of hepatocellular carcinoma after radiofrequency ablation

目的分析磁共振扩散加权成像(DWI)用于肝细胞癌(HCC)患者射频消融(RFA)术后短期侵袭性复发转移的预测价值。方法选取2018年10月—2022年6月本院行RFA术的139例HCC患者,所有患者均行DWI扫描,记录表观扩散系数值(ADC)、癌组织与正常组织表观扩散系数比值(ADC T/L)、指数化表观扩散系数(eADC)和癌组织与正常组织指数化表观扩散系数比值(eADC T/L),并进行多因素logistic回归分析。结果139例HCC患者RFA术后发生复发转移为23.74%;多因素分析结果显示,ADC、ADC T/L和eADC是预测HCC患者RFA术后发生短期侵袭性复发转移的独立危险因素(OR>1,P<0.05);ADC、ADC T/L、eADC、ADC联合ADC T/L、ADC联合eADC、eADC联合ADC T/L和三者联合预测HCC患者RFA术后复发转移的AUC分别为0.668、0.798、0.879、0.822、0.886、0.903和0.849,灵敏度分别为64.60%、79.20%、81.30%、78.30%、87.00%、78.30%和95.80%,特异度分别为69.60%、78.30%、87.00%、80.20%、83.30%、88.50和60.90%。结论ADC、ADC T/L和eADC是HCC患者术后短期侵袭性复发转移的独立预测分子,可作为联合检测指标因子进行预测。

Objective This paper aims to analyze the predictive value of magnetic resonance diffusion weighted imaging(DWI)for short-term invasive recurrence and metastasis in patients with hepatocellular carcinoma(HCC)after radiofrequency ablation(RFA).Methods A total of 139 patients with HCC who underwent RFA in our hospital from October 2018 to June 2022 were selected.All patients underwent DWI scan.The apparent diffusion coefficient(ADC),the ratio of apparent diffusion coefficient of cancer tissue to normal tissue(ADC value T/L),exponential apparent diffusion coefficient(eADC)and the ratio of exponential apparent diffusion coefficient of cancer tissue to normal tissue(eADC value T/L)were recorded,and multivariate logistic regression analysis was performed.Results The recurrence and metastasis of 139 HCC patients after RFA was 23.74%.Multivariate analysis showed that ADC value,ADC T/L and eADC value were independent risk factors for predicting short-term invasive recurrence and metastasis after RFA in HCC patients(OR>1,P<0.05).The AUCs of ADC,ADC T/L,eADC,ADC combined with ADC T/L,ADC combined with eADC,eADC combined with ADC T/L and their combination in predicting recurrence and metastasis of HCC patients after RFA were 0.668,0.798,0.879,0.822,0.886,0.903 and 0.849,respectively,and the sensitivities were 64.60%,79.20%,81.30%,78.30%,87.00%,78.30% and 95.80%,respectively.The specificity was 69.60%,78.30%,87.00%,80.20%,83.30%,88.50% and 60.90%.Conclusion ADC,ADC T/L and eADC are independent predictors for short-term invasive recurrence and metastasis in HCC patients after operation,which can be used as joint detection index factors for prediction.