肝细胞肝癌患者MRI表现及其对微血管侵犯的评估价值

MRI Findings of Hepatocellular Carcinoma Patients and Their Evaluation Value for Microvascular Invasion

目的分析肝细胞肝癌患者磁共振成像(MRI)表现及其对微血管侵犯(MVI)的评估价值。方法选取本院92例接受根治术治疗的肝细胞肝癌患者,均在术前行MRI检查,按照病理学结果,将其分为MVI组与无MVI组,比较两组MRI表现,并以受试者工作特征(ROC)曲线分析MRI表现对MVI的评估价值。结果MVI组与无MVI组肿瘤直径、肿瘤形状比较,差异无统计学意义(P>0.05);MVI组瘤周动脉期强化、肿瘤边缘不光滑占比显著高于无MVI组,差异有统计学意义(P<0.05),肿瘤包膜完整占比显著低于无MVI组,差异有统计学意义(P<0.05);ROC分析显示,瘤周动脉期强化、肿瘤包膜、肿瘤边缘及三项联合评估MVI的曲线下面积(AUC)分别为0.703、0.786、0.753、0.896,三项联合AUC最大,敏感度与特异度分别为90.34%、71.95%。结论肝细胞肝癌患者MRI表现以瘤周动脉期强化、肿瘤边缘不光滑及包膜缺损为主,这些表现联合评估MVI的效能较大,可为MVI评估提供重要指导。

Objective To analyze magnetic resonance imaging(MRI)findings of hepatocellular carcinoma patients and their evaluation value for microvascular invasion(MVI).Methods The paper chose 92 patients with hepatocellular carcinoma with preoperative MRI examination and radical surgery in our hospital,and divided them into MVI group and non MVI group according to pathological results.MRI findings were compared between two groups,evaluation value of MRI findings on MVI was analyzed with receiver operating characteristic(ROC)curve.Results There was no significant difference in tumor diameter and shape between MVI group and non MVI group(P>0.05).Proportion of peritumoral arterial phase enhancement and unsmooth tumor margins in MVI group was significantly higher than non MVI group(P<0.05),proportion of intact tumor envelope was significantly lower than non MVI group(P<0.05).ROC analysis showed area under the curve(AUC)for peritumoral arterial phase enhancement,tumor envelope,tumor margin and combined evaluation of MVI was 0.703,0.786,0.753 and 0.896 respectively.AUC based on combination of three items was the largest,with sensitivity and specificity of 90.34%and 71.95%respectively.Conclusion MRI findings of patients with hepatocellular carcinoma mainly include enhancement of peritumoral arterial phase,unsmooth tumor margins and envelope defects,and combined evaluation of MVI is highly effective,which can provide important guidance for MVI evaluation.