基于多模态MRI影像学表现的logistic回归分析模型对鉴别小肝癌和肝局灶性结节增生的应用价值  

The Application Value of Logistic Regression Analysis Model Based on Multimodal MRI Imaging Manifestations in Differentiating Small Hepatocellular Carcinoma and Focal Nodular Hyperplasia

作　　者：于泳 花村 周晓俞 YU Yong;HUA Cun;ZHOU Xiaoyu(Department of Radiology,Affiliated Yancheng Hospital of Nanjing University of Chinese Medicine,Yancheng,Jiangsu 224001,China;Department of Radiology,The Second Affiliated Hospital of Nantong University,Nantong,Jiangsu 226001,China)

机构地区：[1]南京中医药大学附属盐城中医院<盐城市中医院>影像科,江苏盐城224001 [2]南通大学第二附属医院<南通市第一人民医院>影像科,江苏南通226001

出　　处：《影像研究与医学应用》2023年第12期24-28,共5页Journal of Imaging Research and Medical Applications

基　　金：2019年度盐城市医学科技发展计划项目(YK2019022)。

摘　　要：目的:综合分析小肝癌(small hepatocellular carcinoma,sHCC)和肝局灶性结节增生(focal nodular hyperplasia,FNH)的临床和多模态MRI影像学表现,提高对两者鉴别诊断的水平。方法:选取2015年1月—2022年12月于盐城市中医院经手术病理证实的直径均≤3 cm的79例sHCC和41例FNH患者,综合分析两者临床及多模态MRI影像学表现的差异。结果:与sHCC组相比,FNH组患者发病年龄小,乙肝病史者及临床症状均较少,大部分患者无AFP升高,但病灶中心部分可见瘢痕且不侵犯周围结构,病灶中心在T_(2)WI像易出现高信号,增强后病灶延迟强化常见,但少见包膜/包膜样强化,以上特征差异均具有统计学意义(P<0.05)。logistic回归模型分析显示,鉴别sHCC和FNH的独立危险因素包括平扫AFP升高(OR=22.498)、病灶延迟期相对强化率(OR=8.189)、肿瘤T_(2)WI序列病灶中心高信号(OR=0.017),进一步进行ROC曲线分析,AFP升高、病灶延迟期相对强化率、肿瘤T2WI序列病灶中心高信号的AUC值分别为0.794、0.813、0.834。结论:综合分析患者的临床及MRI影像学特征,有利于提高对sHCC和FNH的鉴别诊断水平。Objective The purpose of this study is to enhance the differential diagnostic accuracy between small hepatocellular carcinoma(sHCC)and focal nodular hyperplasia(FNH)through a comprehensive analysis of their clinical and multimodal MRI manifestations.Methods 79 cases of sHCC and 41 cases of FNH confirmed by surgery and pathology in Yancheng Hospital of Traditional Chinese Medicine from January 2015 to December 2022 were selected,each with a diameter of≤3 cm.We performed a comprehensive analysis of the differences in their clinical and multimodal MRI manifestations.Results Compared to the sHCC group,the FNH group was characterized by a younger age of onset,fewer instances of hepatitis B history,and less clinical symptomatology.The majority of patients in the FNH group did not show an increase in AFP.Notably,a central scar was often identifiable within the lesion,which did not infringe on surrounding structures.On T_(2)WI sequences,a high signal was commonly seen in the center of the lesion,and post-enhancement imaging frequently showed delayed lesion enhancement.However,encapsulation or capsule-like enhancement was rare.All of these features showed significant statistical differences between the two groups(P<0.05).According to logistic regression model analysis,the independent risk factors for differentiating between sHCC and FNH included an increase in AFP(OR=22.498),the relative enhancement rate during the lesion's delayed phase(OR=8.189),and a high signal in the center of the lesion on the T2WI sequence(OR=0.017).Further ROC curve analysis revealed that the AUCs for increased AFP,the relative enhancement rate in the lesion's delayed phase,and a high signal in the center of the lesion on the T_(2)WI sequence were 0.794,0.813,and 0.834,respectively.Conclusion Through a comprehensive analysis of clinical and multimodal MRI features,we can significantly enhance the differential diagnostic accuracy between sHCC and FNH.

关 键 词：多模态MRI 小肝癌 肝局灶性结节增生 logistic回归 

分 类 号：R445.1[医药卫生—影像医学与核医学]