【摘要】：目的探討基于體素內(nèi)不相干運動(IVIM)擴(kuò)散加權(quán)成像(DWI)在肝細(xì)胞癌(HCC)術(shù)前分級中的可行性。方法回顧性分析35例HCC患者的影像學(xué)及病理資料。以Edmondson-Steiner分級法為依據(jù)分為低、高級別組,應(yīng)用雙指數(shù)函數(shù)分別計算兩組的真實擴(kuò)散系數(shù)(D值)、灌注相關(guān)擴(kuò)散系數(shù)(D*值)及灌注分?jǐn)?shù)(f值)。組間比較采用非參數(shù)檢驗Mann-Whitney U,3個參數(shù)間的預(yù)測效能比較用受試者工作特征曲線(ROC)分析,當(dāng)P0.05認(rèn)為差異有統(tǒng)計學(xué)意義。結(jié)果低級別組15例,高級別組20例。低級別組D、D*及f值的均值分別為(1.20±0.32)×10-3mm2/s、(42.57±11.07)×10-3mm2/s、(23.19±10.02)%,高級別組D、D*及f值的均值分別為(0.76±0.18)×10-3mm2/s、(53.89±12.74)×10-3mm2/s、(30.07±12.42)%,與高級別組的HCC相比較,低級別組的D值增大,D*值減小,組間均存在統(tǒng)計學(xué)差異(U=22.5、62.0,P0.05);f值減小,組間不存在統(tǒng)計學(xué)差異(U=82.0,P0.05)。D值、D*值的ROC曲線下面積(AUC)為0.92、0.77,根據(jù)最大約登指數(shù)確定兩者的最佳診斷閾值分別為0.91×10-3mm2/s、53.1×10-3mm2/s。結(jié)論 IVIM DWI對術(shù)前預(yù)測HCC的低、高級別有一定幫助,其中D值的診斷效能最大。
[Abstract]:Objective to investigate the feasibility of intravoxel incoherent motion (IVIM) diffusion weighted imaging (DWI) in the preoperative grading of hepatocellular carcinoma (HCC) with (HCC). Methods the imaging and pathological data of 35 patients with HCC were retrospectively analyzed. According to the Edmondson-Steiner classification method, low and high grade groups were divided into two groups. The real diffusion coefficient (D value), perfusion correlation diffusion coefficient (D * value) and perfusion fraction (f value) of the two groups were calculated by using the double exponential function. Non-parametric test Mann-Whitney-U was used to compare the predictive efficacy of the three parameters, and (ROC) was used to analyze the predictive efficacy of the three parameters. The difference was statistically significant when P0.05 was considered to be significant. Results there were 15 cases in low grade group and 20 cases in high grade group. The mean values of D, D * and f in low-grade group were (1.20 鹵0.32) 脳 10 脳 10 ~ (3) mm ~ (2), (42.57 鹵11.07) 脳 10 ~ (3) mm ~ 2, (23.19 鹵10.02)% and (23.19 鹵10.02)% in high-grade group, respectively. The mean values of D ~ * and f were (0.76 鹵0.18) 脳 10 脳 10 ~ (3) mm ~ (2 / s), (53.89 鹵12.74) 脳 10 脳 10 ~ (3) mm ~ (2) and (30.07 鹵12.42)%, respectively. Compared with high-grade group, the D-value of low-grade group increased and D * value decreased, compared with that of high-grade group, HCC of low-grade group increased and D * value decreased. There were statistical differences between the two groups (U = 22.5, 62.0, P0.05); The area (AUC) under the ROC curve of D value and D * value was 0.92, 0.77, respectively, and there was no statistical difference between the two groups (U = 82.0, P0.05). The optimal diagnostic thresholds are 0.91 脳 10 ~ (- 3) mm ~ (2 / s), 53.1 脳 10 ~ (- 3) mm ~ (2 / s) and 53.1 脳 10 ~ (- 3) mm ~ (2) respectively. Conclusion IVIM DWI is helpful to predict the low and high grade of HCC before operation, among which D value is the most effective.
【作者單位】： 鄭州大學(xué)第一附屬醫(yī)院磁共振科;
【分類號】：R735.7;R445.2

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