体素内不相干运动扩散加权成像对肝细胞癌微血管侵犯的诊断价值  

Diagnosis of Microvascular Invasion in Hepatocellular Carcinoma Using Intravoxel Incoherent Motion Diffusion Weighted Imaging

作　　者：易文中 陈璨 毛志群[3] 丁如 杨智恒 戴琴 Yi Wenzhong;Chen Can;Mao Zhiqun(Department of Radiology,General Hospital of Hunan Medical University,Huaihua 418000,China;Department of Radiology,Changsha Fourth Hospital,Changsha 410006,China;Department of Radiology,Hunan Provincial People's Hospital(the First Affiliated Hospital of Hunan Normal University),Changsha 410005,China)

机构地区：[1]湖南医药学院总医院影像中心,怀化418000 [2]长沙市第四医院放射科,长沙410006 [3]湖南省人民医院(湖南师范大学附属第一医院)放射科,长沙410005

出　　处：《华中科技大学学报(医学版)》2025年第1期86-89,共4页Acta Medicinae Universitatis Scientiae et Technologiae Huazhong

基　　金：湖南省教育厅资助项目(No.20A309);湖南省人民医院(湖南师范大学附属第一医院)医联体专项科研基金资助项目(No.2022YLT004)。

摘　　要：目的探讨使用体素内不相干运动扩散加权成像(IVIM)术前诊断肝细胞癌(HCC)微血管侵犯(MVI)的临床价值。方法回顾性分析2019年至2022年湖南医药学院总医院收治的38例接受手术切除的肝癌患者的临床资料,根据术后病理结果分为MVI阳性组和MVI阴性组,分别测量术前HCC患者扩散加权成像表观扩散系数(ADC)及IVIM真性扩散系数(D)、灌注相关扩散系数(D^(*))、灌注分数(f),分析影响HCC发生MVI的危险因素,采用受试者操作特征曲线(ROC)评估其对MVI的诊断效能。结果MVI阳性组ADC和D值低于阴性组,差异有统计学意义(均P<0.05)。D值曲线下面积(AUC)、特异度、敏感度分别为0.741、68%、94%;ADC值曲线下面积、特异度、灵敏度分别为0.714、50%、88%;两指标联合诊断MVI的曲线下面积0.832、特异度77%、敏感度94%。结论IVIM参数D值和DWI参数ADC值可以帮助术前预测肝细胞癌微血管侵犯,D值的诊断效能优于ADC值。IVIM成像可以提高术前预测肝细胞癌微血管侵犯的准确性。Objective To explore the value of intravoxel incoherent motion diffusion weighted imaging(IVIM)in preoperative diagnosis of microvascular invasion(MVI)in hepatocellular carcinoma(HCC).Methods A retrospective analysis was conducted on the imaging data of 38 hepatocellular carcinoma patients who underwent surgical resection at Hunan Medical College General Hospital from 2019 to 2022.According to postoperative pathology results,they were divided into MVI positive group and MVI negative group.The apparent diffusion coefficient(ADC)of DWI parameters,the true diffusion coefficient(D),perfusion related diffusion coefficient(D~*),and perfusion score(f)of IVIM parameters were measured before surgery in HCC patients.The risk factors affecting the occurrence of MVI in HCC were analyzed,and the diagnostic efficacy of subject operating characteristic curve(ROC)was evaluated for MVI.Results The ADC and D values of the MVI positive group were lower than those of the negative group,with statistical differences(both P<0.05).The area under the D-value curve(AUC),specificity,and sensitivity were 0.741,68%,and 94%,respectively.The area,specificity,and sensitivity under the ADC value curve were 0.714,50%,and 88%,respectively,The area under the curve for the combined diagnosis of MVI by two indicators was 0.832,with a sensitivity of 94%and a specificity of 77%.Conclusion The IVIM parameter D value and DWI parameter ADC value can help to predict microvascular infiltration in hepatocellular carcinoma before surgery,and the diagnostic efficacy of D value is superior to ADC value.IVIM imaging can improve the accuracy of preoperative prediction of microvascular invasion in hepatocellular carcinoma.

关 键 词：肝细胞癌 微血管侵犯 体素内不相干运动 磁共振成像 

分 类 号：R735.7[医药卫生—肿瘤]