磁共振体素内不相干运动成像鉴别肝细胞癌与肝内胆管细胞癌的价值被引量：3

The value of MRI IVIM in identifying hepatocellular carcinoma and intrahepatic cholangiocarcinoma

在线阅读下载PDF

导出

摘要目的探讨磁共振基于体素内不相干运动(intravoxel incoherence motion,IVIM)成像鉴别肝细胞癌(hepatocellular carcinoma,HCC)和肝内胆管细胞癌(intrahepatic cholangiocarcinoma,ICC)的价值。材料与方法回顾性分析我院经病理确诊的43例HCC和17例ICC患者的影像学图像和临床资料。所有患者均在3.0 T MRI上完成IVIM检查,测量并比较病灶的慢扩散系数(slow apparent diffusion coefficient,Dslow)、快扩散系数(fast apparent diffusion coefficient,Dfast)、灌注分数(perfusion fraction,f)、分布扩散系数(distributed diffusion coefficient,DDC)和水分子扩散异质性(water diffusion heterogeneity index,α)值。采用受试者工作特征(receiver operating characteristic,ROC)曲线比较各参数在HCC和ICC组间的诊断效能。结果HCC组病灶Dslow、DDC值均低于ICC组,Dfast值高于ICC组(P均<0.05),f和α值在两组间的差异无统计学意义(P均>0.05)。当Dslow、Dfast和DDC值的最佳阈值分别为0.88×10-3mm2/s、20.82×10-3mm2/s和1.30×10-3mm2/s时,敏感度分别为94.1%、82.4%和82.4%,特异度分别为72.1%、65.1%和67.4%,曲线下面积(area under the curve,AUC)分别为0.846、0.756和0.803。结论基于IVIM的双指数模型和拉伸指数模型有利于鉴别HCC和ICC,其中Dslow的诊断效能最高。 Objective:To explore the value of MRI intravoxel incoherence motion(IVIM)in differentiating hepatocellular carcinoma(HCC)from intrahepatic cholangiocarcinoma(ICC).Materials and Methods:This study included 60 patients with malignant hepatic nodules.All patients underwent IVIM scans on a 3.0 T MRI scanner.The slow apparent diffusion(Dslow),fast diffusion coefficient(Dfast),perfusion fraction(f),distributed diffusion coefficient(DDC)and water diffusion heterogeneity index(α)were obtained.Receiver operating characteristic(ROC)curve analysis was used to compare the efficacy of each parameter in differentiating HCC from ICC.Results:The Dslow and DDC values of lesions in the HCC group were significantly lower than in the ICC group(all P<0.05),the Dfast of lesions in the HCC group were significantly higher than in the ICC group,f andαvalues did not statistically differ between the HCC and ICC groups.When the cut-off values of Dslow,Dfast and DDC were 0.88×10-3 mm2/s,20.82×10-3 mm2/s,and 1.30×10-3 mm2/s,respectively,and the sensitivity was 94.1%,82.4%,82.4%,the specificity was 72.1%,65.1%,67.4%,and the area under the curve(AUC)was 0.846,0.756 and 0.803,respectively.Conclusions:The biexponential model and the stretched exponential model can be used to differentiate HCC from ICC,and the Dslow had the highest diagnostic efficiency.

作者王曦冯苏李红徐敬星胡爽王申 WANG Xi;FENG Su;LI Hong;XU Jingxing;HU Shuang;WANG Shen(Department of Radiology,Affiliated Renhe Hospital of China Three Gorges University,Yichang 443001,China)

机构地区三峡大学附属仁和医院放射科

出处《磁共振成像》 CAS CSCD 北大核心 2023年第7期49-52,85,共5页 Chinese Journal of Magnetic Resonance Imaging

关键词肝细胞癌肝内胆管细胞癌鉴别诊断磁共振成像体素内不相干运动双指数模型拉伸指数模型 hepatocellular carcinoma intrahepatic cholangiocarcinoma differential diagnosis magnetic resonance imaging intravoxel incoherence motion biexponential model stretched model