摘要
目的 目前最小二乘估算法迭代水脂分离序列(IDEAL-IQ)在肝细胞肝癌(HCC)病理分级中的应用较少。文中旨在比较磁共振体素内不相干运动扩散加权成像序列(IVIM-DWI)和IDEAL-IQ序列在HCC术前病理分级中的价值。方法 回顾性收集2019年7月至2021年5月中国科学技术大学附属第一医院安徽省立医院南区影像中心100例行常规MR扫描及IVIM-DWI、IDEAL-IQ扫描高度怀疑HCC患者的临床资料,最终61例HCC患者纳入研究。HCC的分级方法采用Edmondson-Steiner病理分级法,高分化组14例、中分化组30例、低分化组17例。所有患者均行磁共振扫描,包括IVIM-DWI和IDEAL-IQ序列,数据传输至ADW 4.6工作站,测量病灶ADC、D值、D*值、f值、FF值、R2*弛豫率值。采用ROC分析比较ADC、D及FF、R2*检验效能;采用Spearman秩相关ADC、D、FF、R2*与HCC分化程度相关性。结果 高、中、低分化组ADC值、D值、FF值及R2*弛豫率值差异均有统计学意义(P<0.05)。ADC值、D值、FF值、R2*弛豫率与HCC病理分级均呈正相关,分化程度越高,ADC值、D值、FF值、R2*弛豫率值越高(P<0.05)。R2*弛豫率值对高、中分化鉴别诊断效能最高(AUC=0.914),D值对中-低分化的鉴别诊断效能最高(AUC=0.869)。结论 ADC值、D值、FF值、R2*弛豫率值对评估HCC分化程度具有重要参考价值,D值、R2*弛豫率值较ADC值、FF值可以更准确地预测HCC病理学分化程度。
Objective IVIM-DWI is widely used in the pathological grading of hepatocellular carcinoma(HCC),but IDEAL-IQ is not at present.This paper is aimed to explore and compare the value of IVIM-DWI and IDEAL-IQ sequences in the preopera-tive pathological grading of HCC.Methods The clinical data of 100 patients with highly suspected HCC who underwent conventional MR scanning and IVIM-DWI and IDEAL-IQ scanning in the Imaging Center of South District,First Affiliated Hospital of USTC from July 2019 to May 2021 were retrospectively collected,and finally 61 HCC patients were included in the study.Edmondson Steiner pathological grading method was used to grade HCC,including 14 cases in high differentiation group,30 cases in medium differentiation group and 17 cases in low differentiation group.All patients underwent MR scanning,including IVIM-DWI and IDEAL-IQ sequences.The data were transferred to ADW 4.6 workstation to measure the ADC,D value,D*value,f value,FF value and R2*relaxation rate of the lesion.ROC analysis was used to compare the power of ADC,D and FF and R2*tests;Spearman's rank correlation was used to correlate ADC,D,FF,and R2*with HCC differentiation.Results There were significant differences in ADC value,D value,FF value and R2*relaxation rate among high,medium and low differentiation groups of HTSS(P<0.05).ADC value,D value,FF value and R2*relaxation rate were positively correlated with the pathological grade of HCC.The higher the differentiation degree,the higher the ADC value,D value,FF value and R2*relaxation rate(P<0.05).The R2*relaxation rate value had the highest differential diagnostic efficacy for high and medium differentiation(AUC=0.914),and the D value had the highest differential diagnostic efficacy for medium and low differentiation(AUC=0.869).Conclusion ADC,D,FF and R2*values had an important reference value and good correlation for evaluating the differentiation of HCC.D and R2*values could predict the pathological differentiation degree of HCC more accurately than ADC and FF values.
作者
李少朋
邓克学
邱俊
音大为
解义菊
王朋
张锐
LI Shao-peng;DENG Ke-xue;QIU Jun;YIN Da-wei;XIE Yi-ju;WANG Peng;ZHANG Rui(Department of Radiology,The First Affiliated Hospital of USTC,Division of Life Sciences and Medicine,University of Science and Technology of China,Hefei 230036,Anhui,China)
出处
《医学研究生学报》
CAS
北大核心
2022年第2期170-174,共5页
Journal of Medical Postgraduates
基金
2019年度“科大新医学”联合基金项目(WK9110000115)
关键词
肝细胞肝癌
病理分级
磁共振
磁共振体素内不相干运动扩散加权成像序列
最小二乘估算法迭代水脂分离序列
hepatocellular carcinoma
magnetic resonance imaging
histological differentiation
intravoxel incoherent motion diffusion weighted imaging
iterative decomposition of water and fat with echo asymmetry and least squares esti-mation quantification sequence
