1.5T核磁共振动态增强扫描在肝癌分期评估中的临床应用
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摘要
目的探讨1. 5T核磁共振(MRI)动态增强扫描在肝癌分期评估中的临床应用。方法选择86例肝癌患者作为研究对象,记录所有患者的常规1. 5T MRI与动态增强扫描特征,并与病理情况进行对比分析。结果 MRI诊断临床分期为T1期51例,T2期21例,T3期8例,T4期6例。MRI分期与病理分期有较好的一致性(k=0. 892),诊断准确率为96. 5%。常规MRI特征为T1WI呈低信号49例,病灶边缘强化不规则,程度不等;动态增强扫描判断为Ⅰ型36例,Ⅱ型34例,Ⅲ型10例,Ⅳ型6例。MRI评价肝癌可切除性的敏感性、特异性、准确性分别为88. 9%、100. 0%和95. 3%。结论 1. 5T MRI动态增强扫描在肝癌中的应用有助于指导临床病理分期诊断与可切除手术治疗,有很好的应用价值。
Objective To explore the clinical application values of dynamic enhanced scanning1. 5 T magnetic resonance imaging( MRI) in the staging of hepatocellular carcinoma. Methods 86 patients with hepatocellular carcinoma treated were selected. The characteristics of the routine 1. 5 T MRI and dynamic enhanced scanning were recorded and compared with the pathological conditions. Results The clinical stages of MRI were 51 cases in T1 stage,21 cases in T2 stage,8 cases in T3 stage,6 cases in T4 stage,the MRI stage were in good agreement with the pathological stage( k = 0. 892),and the diagnostic accuracy were96. 5%. The routine MRI were characterized by 49 cases of low signal T1 WI,irregular edge enhancement and unequal degree,and there were 36 cases of type Ⅰ,34 cases of type Ⅱ,10 cases of type Ⅲ and 6 cases of type Ⅳ by dynamic enhanced scanning.The sensitivity,specificity and accuracy of MRI in evaluating resectability of hepatocellular carcinoma were 88. 9%,100. 0% and95. 3% respectively. Conclusion The application of 1. 5 T MRI dynamic enhanced scanning in hepatocellular carcinoma is helpful in the diagnosis of clinic staging and the treatment of resectability,and so it has good application value.
Objective To explore the clinical application values of dynamic enhanced scanning1. 5 T magnetic resonance imaging( MRI) in the staging of hepatocellular carcinoma. Methods 86 patients with hepatocellular carcinoma treated were selected. The characteristics of the routine 1. 5 T MRI and dynamic enhanced scanning were recorded and compared with the pathological conditions. Results The clinical stages of MRI were 51 cases in T1 stage,21 cases in T2 stage,8 cases in T3 stage,6 cases in T4 stage,the MRI stage were in good agreement with the pathological stage( k = 0. 892),and the diagnostic accuracy were96. 5%. The routine MRI were characterized by 49 cases of low signal T1 WI,irregular edge enhancement and unequal degree,and there were 36 cases of type Ⅰ,34 cases of type Ⅱ,10 cases of type Ⅲ and 6 cases of type Ⅳ by dynamic enhanced scanning.The sensitivity,specificity and accuracy of MRI in evaluating resectability of hepatocellular carcinoma were 88. 9%,100. 0% and95. 3% respectively. Conclusion The application of 1. 5 T MRI dynamic enhanced scanning in hepatocellular carcinoma is helpful in the diagnosis of clinic staging and the treatment of resectability,and so it has good application value.
引文
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[19] Wang R,Kang B,Hu R,et al. Cl C-3 chloride channel protein induces G1 arrest in hepatocellular carcinoma Hep3B cells〔J〕. Oncol Rep,2018,40(1):472-478.
[20]朱风叶,李红,乔继红,等. CT与MRI在诊断原发性肝癌介入术后病灶残留及复发中的应用价值〔J〕.中国CT和MRI杂志,2018,16(3):76-78.
[21]杨耀文,王志涛,王颖. MR DWI在肝癌TACE术后评估中的应用研究〔J〕.实用放射学杂志,2018,34(4):600-602,605.
[22] Dietrich CF,Potthoff A,Helmberger T,et al. Contrast-enhanced ultrasound:liver imaging reporting and data system(CEUS LI-RADS)〔J〕. Z Gastroenterol,2018,56(5):499-506.
[23]张书伟.螺旋CT和MRI对肝癌TACE术后病灶疗效判断的对比研究〔J〕.现代医用影像学,2017,26(3):552-554.
[24] Kitao A,Matsui O,Yoneda N,et al. Differentiation between hepatocellular carcinoma showing hyperintensity on the hepatobiliary phase of gadoxetic acid-enhanced MRI and focal nodular hyperplasia by CT and MRI〔J〕. AJR Am J Roentgenol,2018,4(30):1-11.
[2]张春雨,付宇,李晓东,等.肝癌的影像学诊断进展〔J〕.临床肝胆病杂志,2017,33(7):1266-1269.
[3] Jiang HY,Chen J,Xia CC,et al. Noninvasive imaging of hepatocellular carcinoma:From diagnosis to prognosis〔J〕.World J Gastroenterol,2018,24(22):2348-2362.
[4]杨淑霞,孙晓飞.超声造影和增强MRI诊断肝硬化基础上肝癌的对比分析〔J〕.影像研究与医学应用,2017,1(10):81-82.
[5] Treilhard J,Smolka S,Staib L,et al. Liver tissue classification in patients with hepatocellular carcinoma by fusing structured and rotationally invariant context representation〔J〕. Med Image Comput Comput Assist Interv,2017,9(10435):81-88.
[6] Wang X,Kwak KJ,Yang Z,et al. Extracellular mRNA detected by molecular beacons in tethered lipoplex nanoparticles for diagnosis of human hepatocellular carcinoma〔J〕.PLo S One,2018,13(6):1-12.
[7]斯兴无,周红俐,陈华平,等. MRI与CT对原发性肝癌TACE术后的疗效评估〔J〕.西部医学,2017,29(8):1150-1153.
[8] Cao QY,Zou ZM,Wang Q,et al. MRI manifestations of hepatic perfusion disorders〔J〕. Exp Ther Med,2018,15(6):5199-5204.
[9] Wang WT,Zhu S,Ding Y,et al. T(1)mapping on gadoxetic acid-enhanced MR imaging predicts recurrence of hepatocellular carcinoma after hepatectomy〔J〕. Eur J Radiol,2018,6(103):25-31.
[10]余炎,吕君,余祖江,等.四种影像学检查评价原发性肝癌患者介入治疗的疗效〔J〕.实用肝脏病杂志,2017,20(2):199-202.
[11] Jung EM,Clevert DA. Contrast-enhanced ultrasound(CEUS)and image fusion for procedures of liver interventions〔J〕. Radiologe,2018,58(6):538-544.
[12] Chen S,Yu W,Zhang K,et al. Transarterial chemoembolization forunresectable hepatocellular carcinoma:A comparison of the efficacy and safety of 2 embolic agents〔J〕. Medicine(Baltimore),2018,97(21):e10832.
[13] Zhao W,Liu W,Liu H,et al. Preoperative prediction of microvascular invasion of hepatocellular carcinoma with IVIM diffusion-weighted MR imaging and Gd-EOB-DTPA-enhanced MR imaging〔J〕. PLo S One,2018,13(5):e0197488.
[14]王月波,陈加源. CT及MRI对原发性肝癌经导管肝动脉化疗栓塞术后疗效评估的对比〔J〕.实用医学杂志,2017,33(18):3110-3114.
[15] Galun D,Bogdanovic A,Djokic Kovac J,et al. Preoperative neutrophil-to-lymphocyte ratio as a prognostic predictor after curative-intent surgery for hepatocellular carcinoma:experience from a developing country〔J〕. Cancer Manag Res,2018,4(10):977-988.
[16] Wiesinger I,Beyer LP,Zausig N,et al. Evaluation of integrated color-coded perfusion analysis for contrast-enhanced ultrasound(CEUS)after percutaneous interventions for malignant liver lesions:First results〔J〕. Clin Hemorheol Microcirc,2018,69(1-2):59-67.
[17]朱玉鹏,张德智,祝英乔.基于磁定位导航的影像融合联合针尖追踪技术引导微波消融治疗肝脏肿瘤1例〔J〕.中国介入影像与治疗学,2018,15(1):63-64.
[18] Park IK,Yu JS,Cho ES,et al. Apparent diffusion coefficient of hepatocellular carcinoma on diffusion-weighted imaging:Histopathologic tumor grade versus arterial vascularity during dynamic magnetic resonance imaging〔J〕. PLo S One,2018,13(5):e0197070.
[19] Wang R,Kang B,Hu R,et al. Cl C-3 chloride channel protein induces G1 arrest in hepatocellular carcinoma Hep3B cells〔J〕. Oncol Rep,2018,40(1):472-478.
[20]朱风叶,李红,乔继红,等. CT与MRI在诊断原发性肝癌介入术后病灶残留及复发中的应用价值〔J〕.中国CT和MRI杂志,2018,16(3):76-78.
[21]杨耀文,王志涛,王颖. MR DWI在肝癌TACE术后评估中的应用研究〔J〕.实用放射学杂志,2018,34(4):600-602,605.
[22] Dietrich CF,Potthoff A,Helmberger T,et al. Contrast-enhanced ultrasound:liver imaging reporting and data system(CEUS LI-RADS)〔J〕. Z Gastroenterol,2018,56(5):499-506.
[23]张书伟.螺旋CT和MRI对肝癌TACE术后病灶疗效判断的对比研究〔J〕.现代医用影像学,2017,26(3):552-554.
[24] Kitao A,Matsui O,Yoneda N,et al. Differentiation between hepatocellular carcinoma showing hyperintensity on the hepatobiliary phase of gadoxetic acid-enhanced MRI and focal nodular hyperplasia by CT and MRI〔J〕. AJR Am J Roentgenol,2018,4(30):1-11.