磁共振扩散张量成像在肝细胞癌及肝转移瘤鉴别诊断价值研究(1)
摘 要：目的 探討磁共振扩散张量成像(DTI)在原发性肝细胞癌(HCC)及肝转移瘤的诊断价值。方法 选取经病理或临床所证实的HCC及肝转移瘤的患者为研究对象，其中HCC 15例，肝转移瘤27例(胰腺癌肝转移瘤8例，结肠癌肝转移瘤7例，胆囊癌肝转移瘤5例，肺癌肝转移瘤3例，食管癌肝转移瘤4例)，所有受试者均行肝脏常规MRI及DTI检查，并进行图像后处理技术，测量各向异性分数(FA)值及平均扩散系数(ADC)值，FA和ADC值均值比较采用多组样本方差分析检验，P<0.05为差异具有统计学意义。结果 肝癌组、胰腺癌肝转移瘤、结直肠癌肝转移瘤、肺癌肝转移瘤、胆囊癌肝转移瘤及食管癌肝转移瘤FA值分别为(0.486±0.0397)、(0.589±0.0461)、(0.292±0.0742)、(0.513±0.1141)、(0.264±0.0529) 和(0.625±0.0262)。上述各组的ADC值分别为(1.71±0.1694)×10-3、(2.02±0.1760)×10-3、(1.85±0.7322)×10-3、(1.51±0.1392)×10-3、(1.19±0.0713)×10-3、(1.66±0.2450)×10-3 mm2/s。肝癌与部分组肝转移瘤FA值及ADC值比较，差异具有统计学意义(P<0.05)，且部分组肝转移瘤之间FA值及ADC值比较差异具有统计学意义(P<0.05)，将部分与肝癌组FA值及ADC值存在差异的肝转移瘤组比较得出的ROC曲线、特异度及灵敏度均有统计学价值。结论 肝脏DTI序列联合常规磁共振成像序列结合可获得更为全面的信息，有助于肝细胞癌及部分肝转移瘤的鉴别诊断。
, 百拇医药
关键词：肝细胞癌；肝转移瘤；扩散张量成像；HCC
中图分类号：R445.2；R735.7 文献标识码：A DOI：10.3969/j.issn.1006-1959.2018.09.004
文章编号：1006-1959(2018)09-0012-04
Abstract：Objective To investigate the diagnostic value of magnetic resonance diffusion tensor imaging(DTI)in primary hepatocellular carcinoma(HCC)and hepatic metastases.Methods Patients with HCC and liver metastases confirmed by pathology or clinic were selected as subjects.There were 15 cases of HCC and 27 cases of hepatic metastases(8 cases of pancreatic liver metastases，7 cases of colon metastases，5 cases of gallbladder liver metastases，3 cases of lung metastases，4 cases of esophageal liver metastases).All subjects underwent conventional liver MRI and DTI examinations，and performed image post-processing techniques to measure anisotropic fraction(FA)values and mean diffusion coefficient(ADC)values.FA and ADC mean values were compared using multi-sample analysis of variance analysis，P<0.05 was considered statistically significant.Results The FA values of liver cancer group，pancreatic cancer liver metastases，colorectal cancer liver metastases，lung cancer liver metastases，gallbladder cancer liver metastases，and esophageal cancer liver metastases were(0.486±0.0397)，(0.589±0.0461)，(0.292±0.0742)，(0.513±0.1141)，(0.264±0.0529)，and(0.625±0.0262).The ADC values of the above groups were(1.71±0.1694)×10-3，(2.02±0.1760)×10-3，(1.85±0.7322)×10-3，(1.51±0.1392)×10-3，(1.19±0.0713)×10-3，(1.66±0.2450)×10-3mm2/s.The difference in FA and ADC values between hepatocellular carcinoma and hepatic metastases in some groups was statistically significant(P<0.05)，and the FA value and ADC value between hepatic metastases in some groups were statistically significant(P<0.05).The ROC curve，specificity and sensitivity of the hepatic metastases group with differences in FA values and ADC values in some liver cancer groups were statistically significant.Conclusion The combination of liver DTI sequence and conventional magnetic resonance imaging sequence can obtain more comprehensive information，which is helpful for the differential diagnosis of hepatocellular carcinoma and some hepatic metastases., 百拇医药(王利娜 赵雪梅 徐云霞 胡孝鹏 王啸 刘福军 钱银锋)
, 百拇医药
关键词：肝细胞癌；肝转移瘤；扩散张量成像；HCC
中图分类号：R445.2；R735.7 文献标识码：A DOI：10.3969/j.issn.1006-1959.2018.09.004
文章编号：1006-1959(2018)09-0012-04
Abstract：Objective To investigate the diagnostic value of magnetic resonance diffusion tensor imaging(DTI)in primary hepatocellular carcinoma(HCC)and hepatic metastases.Methods Patients with HCC and liver metastases confirmed by pathology or clinic were selected as subjects.There were 15 cases of HCC and 27 cases of hepatic metastases(8 cases of pancreatic liver metastases，7 cases of colon metastases，5 cases of gallbladder liver metastases，3 cases of lung metastases，4 cases of esophageal liver metastases).All subjects underwent conventional liver MRI and DTI examinations，and performed image post-processing techniques to measure anisotropic fraction(FA)values and mean diffusion coefficient(ADC)values.FA and ADC mean values were compared using multi-sample analysis of variance analysis，P<0.05 was considered statistically significant.Results The FA values of liver cancer group，pancreatic cancer liver metastases，colorectal cancer liver metastases，lung cancer liver metastases，gallbladder cancer liver metastases，and esophageal cancer liver metastases were(0.486±0.0397)，(0.589±0.0461)，(0.292±0.0742)，(0.513±0.1141)，(0.264±0.0529)，and(0.625±0.0262).The ADC values of the above groups were(1.71±0.1694)×10-3，(2.02±0.1760)×10-3，(1.85±0.7322)×10-3，(1.51±0.1392)×10-3，(1.19±0.0713)×10-3，(1.66±0.2450)×10-3mm2/s.The difference in FA and ADC values between hepatocellular carcinoma and hepatic metastases in some groups was statistically significant(P<0.05)，and the FA value and ADC value between hepatic metastases in some groups were statistically significant(P<0.05).The ROC curve，specificity and sensitivity of the hepatic metastases group with differences in FA values and ADC values in some liver cancer groups were statistically significant.Conclusion The combination of liver DTI sequence and conventional magnetic resonance imaging sequence can obtain more comprehensive information，which is helpful for the differential diagnosis of hepatocellular carcinoma and some hepatic metastases., 百拇医药(王利娜 赵雪梅 徐云霞 胡孝鹏 王啸 刘福军 钱银锋)