磁共振成像多序列对肝内肿块型胆管细胞癌微血管侵犯的预测价值研究  

Predictive Value of Magnetic Resonance Imaging Multiple Sequences for Microvascular Invasion in Intrahepatic Mass Cholangiocarcinoma

作　　者：陈志林[1] 徐秋贞[1] 王孝磊[1] 张明府 周成友 CHEN Zhi-lin;XU Qiu-zhen;WANG Xiao-lei;ZHANG Ming-fu;ZHOU Cheng-you(Department of Radiology,Zhongda Hospital Southeast University(Jiangbei),Nanjing 210044,Jiangsu Province,China;Department of General Surgery,Zhongda Hospital Southeast University(Jiangbei),Nanjing 210044,Jiangsu Province,China;Department of Pathology,Zhongda Hospital Southeast University(Jiangbei),Nanjing 210044,Jiangsu Province,China)

机构地区：[1]东南大学附属中大医院江北院区放射科 [2]东南大学附属中大医院江北院区普外科 [3]东南大学附属中大医院江北院区病理科,江苏南京210044

出　　处：《中国CT和MRI杂志》2024年第7期124-126,共3页Chinese Journal of CT and MRI

基　　金：江苏省卫生健康委医学科研项目(MSXM2021154)。

摘　　要：目的探讨磁共振成像(MRI)多序列对肿块型肝内胆管细胞癌(IMCC)微血管侵犯(MVI)的预测价值。方法回顾性分析2017年1月至2023年1月本院收治的80例IMCC患者的临床资料,术前均行MRI多序列扫描。根据病理结果分为MVI组(24例)和非MVI组(56例),比较两组患者MRI多序列影像特征及相关参数的差异。采用Logistic回归模型确定MVI的影响因素,再通过受试者工作特征曲线(ROC)评估影响因素对MVI的诊断效能。结果本研究IMCC患者中MVI发生率为30.00%。MVI组肿瘤直径、表观扩散系数(ADC)显著高于非MVI组(P<0.05);两组患者之间在肿瘤形态、T1加权图像(T1WI)和T2加权图像(T2WI)信号、有无坏死、强化模式、扩散加权成像(DWI)信号、有无靶征、包膜挛缩以及胆管扩张方面无差异(P>0.05)。采用多因素Logistic回归分析发现ADC值是IMCC患者发生MVI的独立危险因素(P<0.05)。通过绘制ROC曲线分析发现,ADC值预测IMCC患者发生MVI的曲线下面积(AUC)为0.903,敏感度为92.36%,特异度为88.79%,95%CI:85.66%-98.87%;最佳截断阈值为1.45×10^(-3)mm^(2)/s。结论MRI多序列对IMCC患者MVI状态的预测具有良好的诊断效能,其中ADC值可以作为预测MVI发生的独立危险因素,有助于为IMCC患者的精准医疗提供更有价值的术前信息。Objective To Explore the predictive value of magnetic resonance imaging(MRI)multiple sequences for microvascular invasion(MVI)in mass type intrahepatic cholangiocarcinoma(IMCC).Methods Retrospective analysis of the clinical data of 80 IMCC patients admitted to our hospital from January 2017 to January 2023,all of whom underwent preoperative MRI multi sequence scans.According to pathological results,the patients were divided into MVI group(24 cases)and non MVI group(56 cases),and the differences in MRI multi sequence imaging features and related parameters between the two groups were compared.the influencing factors of MVI were determined by Logistic regression model,and the diagnostic efficacy of influencing factors on MVI was evaluated by receiver operating characteristic curve(ROC).Results The incidence of MVI in IMCC patients in this study was 30.00%.The tumor diameter and apparent diffusion coefficient(ADC)in the MVI group were significantly higher than those in the non MVI group(P<0.05);There was no difference between the two groups in tumor morphology,T1 weighted imaging(T1WI)and T2 weighted imaging(T2WI)signals,presence or absence of necrosis,enhancement mode,diffusion weighted imaging(DWI)signals,presence or absence of targets,capsule contracture,and bile duct dilation(P>0.05).Using multivariate logistic regression analysis,it was found that ADC value was an independent risk factor for MVI in IMCC patients(P<0.05).By analyzing the ROC curve,it was found that the Area under the curve(AUC)of predicting MVI in IMCC patients with ADC values was 0.903,with sensitivity of 92.36%,specificity of 88.79%,and 95%CI of 85.66%-98.87%;the optimal cutoff threshold is 1.45×10^(-3)mm^(2)/s.Conclusion MRI multiple sequences have good diagnostic efficacy in predicting the MVI status of IMCC patients,with ADC values serving as independent risk factors for predicting the occurrence of MVI,which helps to provide more valuable preoperative information for precise medical treatment of IMCC patients.

关 键 词：磁共振成像 肝内肿块型胆管细胞癌 微血管侵犯 预测价值 

分 类 号：R445.2[医药卫生—影像医学与核医学] R735.8[医药卫生—诊断学]