肝细胞癌的^1H—MRS和DWI研究  

Study of the Correlation between the Metabolic Changes and Apparent Diffusion Coefficient Value of Hepatocelular Carcinoma

作　　者：董爱生[1] 田建明[2] 陆建平[2] 左长京[1] 王莉[2] 王飞[2] 汪剑[2] 夏谦[2] 

机构地区：[1]第二军医大学长海医院核医学科,上海200433 [2]第二军医大学长海医院放射科,上海200433

出　　处：《临床放射学杂志》2009年第2期214-217,共4页Journal of Clinical Radiology

基　　金：国家自然科学基金项目(批准号:30670590)

摘　　要：目的分析肝细胞癌(hepatocellular carcinoma,HCC)的氢质子磁共振波谱(1H-MRS)及扩散加权成像(DWI)表现,评价HCC代谢物变化与表观扩散系数(ADC)值的相关性。资料与方法对经手术病理证实的29例30个HCC病灶分别进行DWI及单体素波谱分析,测量HCC胆碱峰(Cho)、脂质峰(Lip)的相对浓度及HCC的ADC值,对Cho/(Cho+Lip)比值与ADC值进行线性相关分析。结果30个HCC的Cho/(Cho+Lip)比值及ADC值分别为(0.25±0.21)和(1.49±0.27)mm2/s,HCC的Cho/(Cho+Lip)比值与ADC值呈负相关(P<0.05)。质地均一、无明显出血坏死HCC(n=10)的Cho/(Cho+Lip)比值明显升高,ADC值明显下降;不均质局灶出血坏死HCC(n=13)的Cho/(Cho+Lip)比值轻度下降,ADC值轻度升高;明显脂肪变性(n=2)及透明细胞型(n=2)HCC的Cho/(Cho+Lip)比值很低,但是ADC值无明显升高;纤维基质丰富、无明显坏死、质地均一HCC(n=3)的Cho/(Cho+Lip)比值及ADC值均较低。结论1H-MRS与ADC值结合能基本反映HCC的肿瘤组织成分变化,有助于HCC的诊断、鉴别诊断和活体肿瘤成分分析。Objective Proton magnetic resonance spectroscopy（1H MRS） and diffusion weighted imagine （DWI） can provide the functional information about the hepatocellular carcinoma. This study was to evaluate the correlation between the metabolic changes and apparent diffusion coefficient（ADC） value. Materials and Methods 29 patients with 30 HCCs underwent both DWI and ^1H MRS study. The relevant concentration of choline（Cho） and lipid（Lip） of HCC was measured on ^1H MRS, and Cho/（ Cho ＋ Lip） ratio was calculated. At the correspondent slices of the same HCC the ADC was measured On the DWI scan. The correlation between Cho/（ Cho ＋ Lip） ratios and ADCs was analyzed by linear correlation test （P〈0.05）. Results The Cho/（Cho＋Lip） ratios and ADCs of 30 HCCS were （1.49 ±0.27） mm^2/sec and 0.25± 0.21 respectively. There was a negative correlation between Cho/（ Cho ＋ Lip） ratios and ADCs （P 〈 0.05 ）. The Cho/ （ Cho ＋ Lip）ratios was significantly increased and the ADCs was significantly decreased in the HCC （n = 10） with little necrosis. The Cho/（Cho ＋ Lip）ratios was slightly decreased and the ADCs was slightly increased in the HCC（ n = 13） with part of necrosis. The Cho/（ Cho ＋ Lip）ratios was significantly decreased and the ADCs was no increased in the HCC （n = 2 ） with obvious fatty changes and HCC（ n = 2） with clear cell change. Both the Cho/（ Cho ＋ Lip） ratios and the ADCs were slightly decreased in the HCC（n = 3） with much fibrotic matrix and little necrosis. Conclusion The metabolic changes and ADC of the HCC reflected the information about the components of tumor tissue. So the different tissues should be taken into accounted when the metabolic changes and ADC of HCC were analyzed.

关 键 词：肝细胞癌 磁共振波谱分析 扩散加权成像 

分 类 号：R735.7[医药卫生—肿瘤] R743.33[医药卫生—临床医学]