多模态MRI对孤立性肝细胞癌微血管侵犯病理相关性研究  

The pathological correlation study of multimodal MRI on microvascular invasion of solitary hepatocellular carcinoma

作　　者：吴杰 肖安岭[1] 刘涛[2] 李卫[3] 罗大勇[3] 无 WU Jie;XIAO Anling;LIU Tao;LI Wei;LUO Dayong;无(MRI Room,the Second People's Hospital of Fuyang,Fuyang,Anhui Province 236015,China;Department of Pathology,the Second People's Hospital of Fuyang,Fuyang,Anhui Province 236015,China;Department of Hepatology,the Second People's Hospital of Fuyang,Fuyang,Anhui Province 236015,China;Department of Hepatobiliary Surgery,the Second People's Hospital of Fuyang,Fuyang,Anhui Province 236015,China)

机构地区：[1]阜阳市第二人民医院MRI室,安徽阜阳236015 [2]阜阳市第二人民医院病理科,安徽阜阳236015 [3]阜阳市第二人民医院肝病科,安徽阜阳236015 [4]阜阳市第二人民医院肝胆外科,安徽阜阳236015

出　　处：《实用放射学杂志》2022年第11期1803-1806,共4页Journal of Practical Radiology

基　　金：阜阳市卫生健康委员会科研立项课题(FY2021-055);阜阳市科技局科研计划项目(FK202081054).

摘　　要：目的探讨多模态MRI检查对孤立性肝细胞癌微血管侵犯(MVI)的诊断价值.方法选取50例孤立性肝细胞癌根治术患者,所有患者术前均行多模态MRI检查,术后依据病理分为MVI阳性组(20例)和MVI阴性组(30组),研究性别、年龄、肿瘤边界、肿瘤包膜、动脉期瘤周强化、肿瘤直径、表观扩散系数(ADC)、甲胎蛋白(AFP)等因素与肿瘤MVI的相关性.采用多因素Logistic相关性分析,确定MVI的独立影响因素.结果MVI阳性组和MVI阴性组之间性别、年龄及AFP值无统计学差异(P>0.05);2组之间肿瘤边界、肿瘤包膜、动脉期瘤周强化、肿瘤直径、ADC值有统计学差异(P<0.05);肿瘤直径及动脉期瘤周强化是肿瘤MVI的独立影响因素(P<0.05);肝胆期瘤周低信号也是肿瘤MVI重要影响因素之一.结论肿瘤边界、肿瘤包膜、动脉期瘤周强化、肿瘤直径、ADC值,肝胆期瘤周低信号可用于术前评估肝细胞癌有无MVI,肿瘤直径及动脉期瘤周强化可作为预测肝细胞癌有无MVI的独立危险因素,多模态MRI能对孤立性肝细胞癌MVI术前准确评估.Objective To explore the diagnostic value of multimodal MRI for microvascular invasion(MVI)of solitary hepatocellular carcinoma.Methods A total of 50 patients with solitary hepatocellular carcinoma undergoing radical resection were selected.All patients underwent multimodal MRI examination before operation,and were divided into MVI positive group(20 cases)and MVI negative group(30 cases)based on pathology after operation.To study the correlation between factors such as gender,age,tumor boundary,tumor capsule,peritumoral arterial enhancement,tumor diameter,apparent diffusion coefficient(ADC),alpha-fetoprotein(AFP)and tumor MVI.Multivariate Logistic correlation analysis was used to determine the independent influence factors of MVI.Results There was no significant difference between the MVI positive group and MVI negative group in gender,age and AFP(P>0.05),and there were significant differences in tumor boundary,tumor capsule,peritumoral arterial enhancement,tumor diameter and ADC between the two groups(P<0.05).Tumor diameter and peritumoral arterial enhancement were independent influencing factors of tumor MVI(P<0.05).Peritumoral hypointensity in hepatobiliary phase was also one of the important influencing factors of tumor MVI.Conclusion The tumor boundary,tumor capsule,peritumoral arterial enhancement,tumor diameter,ADC value and peritumoral hypointensity in hepatobiliary phase can be used to evaluate whether hepatocellular carcinoma has MVI before operation.The tumor diameter and peritumoral arterial enhancement can be used as independent risk factors to predict whether hepatocellular carcinoma has MVI.Multimodal MRI can accurately evaluate MVI of solitary hepatocellular carcinoma before operation.

关 键 词：肝细胞癌 微血管侵犯 磁共振成像 

分 类 号：R445.2[医药卫生—影像医学与核医学] R735.7[医药卫生—诊断学]