磁共振IVIM-DWI联合CT对肝细胞癌病理分级的评估价值

Value of IVIM-DWI Combined with CT in Evaluating the Pathological Grading of Hepatocellular Carcinoma

目的分析磁共振体素内不相干运动扩散加权成像序列(IVIM-DWI)与CT联合对肝细胞癌(HCC)病理分级的评估价值。方法选取2020年1月~2022年1月期间本院收治的HCC患者89例,根据术后病理结果将患者分为高分化组53例,低分化组36例,采用IVIM-DWI法评估两组患者ADC、D、D*、f值,根据ADC、D、D*值对HCC患者进行分级,并评估结果与术后病理结果的一致性,采用CT法比较两组患者CT影像特征,并评估结果与术后病理结果的一致性,采用四表格法分析IVIM-DWI、CT以及二者联合对HCC患者低分化的诊断价值。结果与高分化组相比,低分化组ADC、D、D*值降低(P<0.05);ADC、D、D*联合检测对低分化的诊断曲线下面积为0.927(敏感度为97.2%,特异性为77.4%);磁共振IVIM-DWI检测出高分化42例,低分化47例,与术后病理切片诊断结果一致性较高(P<0.05);CT检测出高分化58例,低分化31例,与术后病理切片诊断结果一致性较高(P<0.05),磁共振IVIM-DWI与CT联合检测出高分化55例,低分化34例,与术后病理切片诊断结果一致性较高(P<0.05)。结论IVIM-DWI与CT联合检测对HCC的病理分级具有一定评估价值。

Objective To analyze the value of incoherent motion diffusion weighted imaging sequence(IVIM-DWI)combined with CT in evaluating the pathological grading of hepatocellular carcinoma(HCC).Methods A total of 89 patients with HCC admitted to our hospital from January 2020 to January 22 were selected.According to the postoperative pathological results,the patients were grouped into well differentiated group(53 cases)and poorly differentiated group(36 cases),IVIM-DWI method was used to evaluate the ADC,D,D*and f values of the two groups,and the HCC patients were graded according to the ADC,D,D*values,and the consistency between the results and the postoperative pathological results was evaluated,CT method was applied to compare the CT image characteristics of the two groups and the consistency between the results and the postoperative pathological results was evaluated,the diagnostic value of IVIMDWI,CT and the combination of IVIM-DWI and CT in HCC patients with low differentiation was analyzed by four-table method.Results Compared with the well differentiated group,the values of ADC,D,D*in the poorly differentiated group were lower(P<0.05);the area under the diagnostic curve of the combined detection of ADC,D and D*for low differentiation was 0.927(sensitivity of 97.2%,specificity of 77.4%);magnetic resonance IVIM-DWI detected 42 cases of high differentiation and 47 cases of low differentiation,which were consistent with the diagnosis results of postoperative pathological sections(P<0.05);58 cases of high differentiation and 31 cases of low differentiation were detected by CT,which were consistent with the diagnosis results of postoperative pathological section(P<0.05),magnetic resonance IVIM-DWI and CT jointly detected 55 cases of high differentiation and 34 cases of low differentiation,which were consistent with the diagnosis results of postoperative pathological section(P<0.05).Conclusion The combined detection of IVIM-DWI and CT has certain evaluation value for the pathological grading of HCC.