基于MRI的多模式影像学检查在HBV相关性肝癌介入术后预后评估中应用价值  

Value of MRI-based multimodality imaging in prognostic assessment of HBV-associated hepatocellular carcinoma after interventional procedures

作　　者：韩承儒 杜森 赵森[1] HAN Cheng-ru;DU Sen;ZHAO Sen(Department of Medical Imaging,the First Affiliated Hospital of Henan University,Kaifeng,Henan 475200,China)

机构地区：[1]河南大学第一附属医院医学影像科,河南开封475200

出　　处：《医药论坛杂志》2025年第2期221-224,F0003,共5页Journal of Medical Forum

基　　金：开封市科技发展计划项目(2103015)。

摘　　要：目的 探讨磁共振成像技术(magnetic resonance imaging,MRI)的多模式参数预测乙型肝炎病毒感染(hepatitis B virus,HBV)相关性肝癌介入术后预后价值。方法 选取2022年1月—2023年1月河南大学第一附属医院160例行HBV相关性肝癌介入术患者作为研究对象,术后进行为期12个月的随访,失访4例,根据复发情况分为复发组(n=32)和未复发组(n=124)。统计两组一般资料、MRI多模式参数,logistic回归方程分析HBV相关性肝癌介入术后预后影响因素,绘制森林图,决策曲线(decision curve analysis,DCA)分析MRI多模式参数临床获益度。结果 两组HBV-DNA、甲胎蛋白(alpha-fetoprotein,AFP)及包膜侵犯比较,差异有统计学意义(P<0.05);复发组表观扩散系数(apparent diffusion coefficient,ADC)低于未复发组,血管外细胞外间隙体积分数(extracellular volume fraction,Ve)、速率常数(exchange rate constant,Kep)、组织容积灌注参数(volume transfer constant,K^(trans))高于未复发组(P<0.05);logistic回归方程显示,ADC、Ve、Kep、K^(trans)是HBV相关性肝癌介入术后预后不良影响因素(P<0.05);森林图显示,Ve>0.59、Kep>0.63 min^(-1)、K^(trans)>0.38 min^(-1)为正相关危险因素,ADC>0.92×10^(-3)mm^(2)/s为负相关保护因素,与无效线不相交,P均<0.05;DCA曲线显示,联合ADC、Ve、Kep、K^(trans)的预测模型结果优于各参数单一诊断结果,差异有统计学意义(P<0.05)。结论 MRI多模式参数(ADC、Ve、Kep、K^(trans))是HBV相关性肝癌介入术后预后影响因素,四者联合具有良好预测效能,有助于指导临床诊治,促进预后改善。Objective To explore the prognostic value of multi-mode parameters of magnetic resonance imaging(MRI)in predicting the post-interventional prognosis of hepatitis B virus(HBV)infection-associated hepatocellular carcinoma.Methods Totally 160 patients with HBV-associated hepatocellular carcinoma intervention in the First Affiliated Hospital of Henan University from January 2022 to January 2023 were selected for the study,with a 12-month postoperative follow-up and 4 lost cases,which were divided into recurrence group(n=32) and non-recurrence group(n=124) according to recurrence.The general data,MRI multimodal parameters of the 2 groups were counted,and logistic regression equation was used to analyze the factors influencing the prognosis after HBV-related hepatocellular carcinoma intervention,and forest plot and decision curve analysis(DCA) were drawn to analyze the degree of clinical benefit of MRI multimodal parameters.Results When comparing HBV-DNA,alpha-fetoprotein(AFP) and envelope invasion between the two groups,and the differences were statistically significant(P<0.05);apparent diffusion coefficient(ADC) was lower in the recurrence group than that in the non-recurrence group,and extracellular volume fraction(Ve),exchange rate constant(Kep),volume transfer constant(K^(trans)) were higher than those in the non-recurrence group(P<0.05);logistic regression equation showed that ADC,Ve,Kep and K^(trans) were the prognosis of HBV-associated hepatocellular carcinoma after intervention adverse influencing factors(P<0.05).Forest plot showed that Ve>0.59,Kep>0.63 min^(-1),K^(trans)>0.38 min^(-1) were positively associated risk factors,and ADC>0.92×10^(-3)mm^(2)/s was a negatively associated protective factor,which did not intersect with the null line,all with P<0.05;DCA curves showed that the prediction model results of combined ADC,Ve,Kep,and K^(trans) were better than the single diagnostic results of each parameter,and the differences were statistically significant(P<0.05).Conclusion MRI multimodal parameters(ADC,Ve,

关 键 词：乙型肝炎病毒感染 肝癌介入术 磁共振成像 多模式影像学检查 预后 

分 类 号：R445.2[医药卫生—影像医学与核医学]