MRI多序列扫描在肝细胞癌诊断和微血管侵犯评估中的应用价值  

Application Value of MRI Multi-sequence Scan in the Diagnosis of Hepatocellular Carcinoma and Evaluation of Microvascular Invasion

作　　者：陈泳松 王德芬 陈海洋 赵方 陈廷昊 陈泽胜 CHEN Yong-song;WANG De-fen;CHEN Hai-yang;ZHAO Fang;CHEN Ting-hao;CHEN Ze-sheng(Hepatobiliary and Pancreatic Surgery;Emergency Department,Ziyang Hospital West China Hospital of Sichuan University Ziyang Central hospital,Ziyang,Sichuan,641300,China)

机构地区：[1]四川大学华西医院资阳医院/资阳市中心医院肝胆胰外科,四川资阳641300 [2]四川大学华西医院资阳医院/资阳市中心医院急诊科,四川资阳641300

出　　处：《现代生物医学进展》2024年第17期3310-3315,共6页Progress in Modern Biomedicine

基　　金：四川省医学科研项目(S17083)。

摘　　要：目的:探讨磁共振(MRI)多序列扫描在肝细胞癌(HCC)诊断和微血管侵犯(MVI)评估中的应用价值。方法:回顾性选取2019年10月-2022年10月在本院收治的疑似100例HCC患者临床资料,均已完善MRI多序列扫描检查和病理检查,以病理检查为金标准,利用Kappa检验分析MRI多序列扫描在肝细胞癌诊断和微血管侵犯评估与病理检查的一致性。结果:100例患者经病理检测,有51例患者确诊为HCC(51.00%),有49例患者为良性肝脏病变(49.00%)。51例HCC中存在MVI 17例(33.33%)。与病理结果比较,T2WI序列诊断HCC的敏感度为82.35%,特异度为79.59%,Kappa值为0.620,诊断MVI的敏感度为64.71%,特异度为85.29%,Kappa值为0.507;T1WI序列诊断HCC的敏感度为76.47%,特异度为81.63%,Kappa值为0.580,诊断MVI的敏感度为58.82%,特异度为88.24%,Kappa值为0.492;LAVA序列诊断HCC的敏感度为84.31%,特异度为83.67%,Kappa值为0.580,诊断MVI的敏感度为64.71%,特异度为91.18%,Kappa值为0.585;MRI多序列联合诊断HCC的敏感度为96.08%,特异度为79.59%,Kappa值为0.759,诊断MVI的敏感度为94.12%,特异度为82.35%,Kappa值为0.712。MRI多序列联合诊断HCC和MVI的敏感度均高于单独序列(P<0.05)。MVI阳性者肿瘤边缘形态不光滑型、有瘤周强化占比高于MVI阴性者(P<0.05)。结论:MRI多序列成像可有助于临床HCC诊断及MVI评估,具有较好的应用价值;肿瘤边缘形态不光滑、瘤周强化在预测HCC MVI方面有意义。Objective:To explore the application value of magnetic resonance imaging(MRI)multi-sequence scan in the diagnosis of hepatocellular carcinoma(HCC)and evaluation of microvascular invasion(MVI).Methods:A retrospective collection was performed on the clinical data of 100 patients with suspected HCC in the hospital between October 2019 and October 2022.All completed MRI multi-sequence scan and pathological examination.Taking pathological examination as the golden standard,the consistency between MRI multi-sequence scan and pathological examination in the diagnosis of HCC and evaluation of MVI was analyzed by Kappa test.Results:Among the 100 patients,pathological examination showed that there were 51 cases(51.00%)with HCC and 49 cases(49.00%)with benign liver lesions.In the 51 HCC patients,there were 17 cases(33.33%)with MVI.Taking pathological examination as the golden standard,sensitivity,specificity and Kappa values of T2WI in the diagnosis of HCC and MVI were(82.35%,79.59%,0.620)and(64.71%,85.29%,0.507),respectively.The sensitivity,specificity and Kappa values of T1WI in the diagnosis of HCC and MVI were(76.47%,81.63%,0.580)and(58.82%,88.24%,0.492),respectively.The sensitivity,specificity and Kappa values of LAVA in the diagnosis of HCC and MVI were(84.31%,83.67%,0.580)and(64.71%,91.18%,0.585),respectively.The sensitivity,specificity and Kappa values of MRI multi-sequence scan in the diagnosis of HCC and MVI were(96.08%,79.59%,0.759)and(94.12%,82.35%,0.712),respectively.The sensitivity of MRI multi-sequence scan was higher than that of single sequence(P<0.05).The proportions of unsmooth tumor edge and peritumoral enhancement in patients with MVI positive were higher than those with MVI negative(P<0.05).Conclusion:MRI multi-sequence scan is conductive to clinical diagnosis of HCC and evaluation of MVI.Unsmooth tumor edge and peritumoral enhancement have predictive significance in HCC and MVI.

关 键 词：磁共振 多序列成像 肝细胞癌 微血管侵犯 诊断 一致性 

分 类 号：R735.7[医药卫生—肿瘤]