磁共振弥散加权成像联合超声造影在预测肝细胞癌微血管侵犯中的价值  

The value of MR DWI combined with ultrasound contrast in predictiong MVI of HCC

作　　者：汪荣[1] 黄红梅[1] 周静[1] 严稳开 WANG Rong;HUANG Hong-mei;ZHOU Jing(Department of Ultrasound,Ezhou Central Hospital,Ezhou 436000,China)

机构地区：[1]鄂州市中心医院超声科,湖北鄂州436000

出　　处：《中国医学装备》2020年第6期66-70,共5页China Medical Equipment

摘　　要：目的:探讨磁共振弥散加权成像(DWI)联合超声造影在预测肝细胞癌(HCC)微血管侵犯(MVI)中的价值。方法:选取在医院就诊的117例HCC患者,根据是否存在MVI现象将其分为MVI阳性组(52例)和MVI阴性组(65例),对两组患者在实施外科手术切除治疗前均行磁共振DWI、超声造影检查。比较两组患者磁共振DWI平均表观弥散系数(ADC)值和廓清时间、始增时间、达峰时间等超声造影定量参数,采用受试者工作特征(ROC)曲线下面积(AUC)分析磁共振DWI、超声造影及两者联合预测MVI的临床价值。结果:MVI阳性组患者磁共振DWI平均ADC值为(1.02±0.22)×10^-3 mm^2/s,明显低于MVI阴性组患者的(1.18±0.25)×10^-3 mm^2/s,(t=2.948,P<0.05),患者廓清时间较MVI阴性组患者明显缩短,两组比较差异有统计学意义(t=4.572,P<0.05),而两组始增时间和达峰时间等超声造影定量参数比较无显著性差异(t=0.279,t=0.251;P>0.05)。磁共振DWI平均ADC值最佳截点时,AUC值为0.617,诊断灵敏度为73.08%,特异度为67.69%;超声造影定量参数廓清时间最佳截点时,AUC值为0.742,诊断灵敏度为76.92%,特异度为66.15%;两者联合预测MVI的AUC(0.895)明显优于单一方法检查(t=7.673,t=4.968;P<0.05),两者联合预测MVI的灵敏度为90.38%,特异度为87.69,均明显优于单一方法检查(x灵敏度2=4.940,x^2=4.713;x特异度2=5.014,x^2=5.064;P<0.05)。结论:磁共振DWI的平均ADC值联合超声造影的廓清时间诊断方法在预测HCC患者MVI具有较高的临床价值。Objective:To investigate the value of magnetic resonance diffusion weighted imaging(MR DWI)combined with contrast in predictiong micro-vascular invasion(MVI)of hepatocellular carcinoma(HCC).Methods:117 HCC patients admitted to hospitals were selected,and they were divided into MVI positive group(52 cases)and MVI negative group(65 cases)according to whether MVI phenomenon existed in them.All of patients underwent MR DWI and ultrasound examination before surgery resection was implemented.The series of quantitative parameters included average apparent diffusion coefficient(ADC)value of MR DWI,clearance time,initial increase time,peak time of ultrasound contrast between the two groups were compared.The area under curve(AUC)of receiver operating characteristics(ROC)curve was adopted to analyze the clinical values of MR DWI,ultrasound contrast and the combination of the two methods in predicting MVI.Results:The mean of DWI ADC value of MVI positive group[(1.02±0.22)×10-3mm2/s]was significantly lower than that of MVI negative group[(1.18±0.25)×10-3mm2/s](t=2.948,P<0.05).The clearance time of the patients of MVI positive group was significantly shorter than that of MVI negative group(t=4.572,P<0.05),while there were no significant difference in other quantitative parameters of ultrasound contrast such as the initial increase time and peak time between the two groups(t=0.279,t=0.251,P>0.05).When the average ADC values of MR DWI were at the best cutoff point,AUC was 0.617,and the diagnostic sensitivity and specificity were 73.08% and 67.69%,respectively.When the clearance time of quantitative parameter of ultrasound contrast was the best cutoff point(78.23 s),AUC was 0.742,and diagnostic sensitivity and specificity were 76.92% and 66.15%,respectively.The AUC(0.895)of the combined method in predicting MVI was significantly better than that of any single method(t=7.673,t=4.968,P<0.05).And the sensitivity and specificity of the combined method in predicting MVI were 90.38%and 87.69,both of which of the combined method wer

关 键 词：磁共振扩散加权成像(MR DWI) 超声造影 肝细胞癌(HCC) 微血管侵犯(MVI) 

分 类 号：R445.2[医药卫生—影像医学与核医学]