DCE-MRI定量参数用于肝细胞癌与肝良性占位的诊断效能分析
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摘要
目的分析DCE-MRI定量参数用于肝细胞癌(HCC)与肝良性占位的诊断效能。方法选择肝病患者共66例,根据穿刺活检结果分为HCC组(24例)和良性组(42例)。应用DCE-MRI检查每位患者病灶以及病灶周围正常肝组织的容积转移常数(K~(trans))、运动速率常数(K_(ep))、血管外细胞外容积分数(V_e)、增强曲线下初始面积(iAUC)。对比每组病灶与周围正常肝组织、肝良性占位与HCC的K~(trans)、K_(ep)、V_e、iAUC,并计算界值、敏感性以及特异性。结果肝良性占位以及HCC的K~(trans)、K_(ep)、iAUC均显著高于病灶周围正常肝组织(P<0.05),并且HCC的K~(trans)、K_(ep)、iAUC均显著高于肝良性占位(P<0.05)。K~(trans)界值为0.217 min~(-1),敏感性82.6%,特异性67.2%;K_(ep)界值为0.479 min~(-1),敏感性75.7%,特异性58.9%;0.743界值为24.81,敏感性81.9%,特异性59.0%。结论 HCC与肝良性占位的DCE-MRI定量参数有着显著差异,其中K~(trans)界值为0.217 min~(-1)具有最高的诊断效能。
Objective To analyse the diagnostic efficacy of DCE-MRI quantitative parameters on hepatocellular carcinoma and benign liver lesions. Methods 66 patients with liver disease were selected from June 2015 to June 2017. According to the results of biopsy,they were divided into HCC group(n=24) and benign group(n=42).The volume transfer constant(K~(trans)),exercise rate constant(K_(ep)),extracellular extracellular volume fraction(V_e),and initial area under curve(iAUC) of each patient's lesion and surrounding normal liver tissue were examined using DCE-MRI. Compared each group of lesions with the surrounding normal liver tissue,benign liver lesions and HCC K~(trans),K_(ep),V_e,iAUC,The cutoff,sensitivity and specificity(%) were calculated. Results Liver benign mass and K~(trans),K_(ep),iAUC of HCC were significantly higher than normal liver tissue around the lesion(P<0.05). And K~(trans),K_(ep),V_e,iAUC of HCC were significantly higher than that of benign liver(P<0.05).The K~(trans) cutoff value was 0.217 min~(-1) with a sensitivity of 82.6% and a specificity of 67. 2%. The Ke p cutoff was 0. 479 min-1 with a sensitivity of 75. 7% and a specificity of 58. 9%. The cutoff of 0. 743 was 24. 81 with a sensitivity of 81. 9% Sex 59. 0%. Conclusion The quantitative parameters of DCE-MRI in benign liver lesions and HCC were significantly different. The Kt rans cutoff value of 0. 217 min-1 had the highest diagnostic efficacy.
Objective To analyse the diagnostic efficacy of DCE-MRI quantitative parameters on hepatocellular carcinoma and benign liver lesions. Methods 66 patients with liver disease were selected from June 2015 to June 2017. According to the results of biopsy,they were divided into HCC group(n=24) and benign group(n=42).The volume transfer constant(K~(trans)),exercise rate constant(K_(ep)),extracellular extracellular volume fraction(V_e),and initial area under curve(iAUC) of each patient's lesion and surrounding normal liver tissue were examined using DCE-MRI. Compared each group of lesions with the surrounding normal liver tissue,benign liver lesions and HCC K~(trans),K_(ep),V_e,iAUC,The cutoff,sensitivity and specificity(%) were calculated. Results Liver benign mass and K~(trans),K_(ep),iAUC of HCC were significantly higher than normal liver tissue around the lesion(P<0.05). And K~(trans),K_(ep),V_e,iAUC of HCC were significantly higher than that of benign liver(P<0.05).The K~(trans) cutoff value was 0.217 min~(-1) with a sensitivity of 82.6% and a specificity of 67. 2%. The Ke p cutoff was 0. 479 min-1 with a sensitivity of 75. 7% and a specificity of 58. 9%. The cutoff of 0. 743 was 24. 81 with a sensitivity of 81. 9% Sex 59. 0%. Conclusion The quantitative parameters of DCE-MRI in benign liver lesions and HCC were significantly different. The Kt rans cutoff value of 0. 217 min-1 had the highest diagnostic efficacy.
引文
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14 章俞,胡红杰,赵振华.动态对比增强MRI功能成像参数对肝细胞肝癌和肝转移瘤的鉴别诊断价值[J].临床放射学杂志,2016,35:1376-1380.
2 Hawnaur JM,Zhu XP,Hutchinson CE.Quantitative dynamic contrast enhanced MRI of recurrent pelvic masses in patients treated for cancer[J].British Journal of Radiology,2014,71:1136-1142.
3 Flores A,Marrero JA.Emerging Trends in Hepatocellular Carcinoma:Focus on Diagnosis and Therapeutics[J].Clinical Medicine Insights Oncology,2014,8:71-76.
4 Tao LC,Ho CS,Mcloughlin MJ,et al.Cytologic diagnosis of hepatocellular carcinoma by fine-needle aspiration biopsy[J].Cancer,2015,53:547-552.
5 AAttwa MH,El-Etreby SA.Guide for diagnosis and treatment of hepatocellular carcinoma[J].World Journal of Hepatology,2015,7:1632-1651.
6 Chen BB,Hsu CY,Yu CW,et al.Dynamic Contrast-enhanced MR Imaging of Advanced Hepatocellular Carcinoma:Comparison with the Liver Parenchyma and Correlation with the Survival of Patients Receiving Systemic Therapy[J].Radiology,2016,281:454-464.
7 Zheng D,Chen Y,Chen Y,et al.Dynamic contrast-enhanced MRI of nasopharyngeal carcinoma:a preliminary study of the correlations between quantitative parameters[J].Journal of Magnetic Resonance Imaging,2014,39:940-948.
8 Kickingereder P,Wiestler B,Graf M,et al.Evaluation of dynamic contrast-enhanced MRI derived microvascular permeability in recurrent glioblastoma treated with bevacizumab[J].Journal of Neuro-oncology,2015,121:373-380.
9 Kierans AS,Kang SK,Rosenkrantz AB.The Diagnostic Performance of Dynamic Contrast-enhanced MR Imaging for Detection of Small Hepatocellular Carcinoma Measuring Up to 2 cm:A Meta-Analysis[J].Radiology,2016,278:82-94.
10 李跃明,邢振,林娜,等.3.0T MRI在小肝细胞癌与肝脏局灶性结节增生中的鉴别诊断价值[J].中国医学影像学杂志,2014,22:501-504.
11 Prasad P,Gordijo CR,Abbasi AZ,et al.Multifunctional albumin-MnO2 nanoparticles modulate solid tumor microenvironment by attenuating hypoxia,acidosis,vascular endothelial growth factor and enhance radiation response[J].Acs Nano,2014,8:3202-3212.
12 Ji YK,Kim SH,Yun JK,et al.Enhancement parameters on dynamic contrast enhanced breast MRI:do they correlate with prognostic factors and subtypes of breast cancers?[J].Magnetic Resonance Imaging,2015,33:72-80.
13 Huang W,Li X,Chen Y,et al.Variations of Dynamic Contrast-Enhanced Magnetic Resonance Imaging in Evaluation of Breast Cancer Therapy Response:A Multicenter Data Analysis Challenge[J].Translational Oncology,2014,7:153-166.
14 章俞,胡红杰,赵振华.动态对比增强MRI功能成像参数对肝细胞肝癌和肝转移瘤的鉴别诊断价值[J].临床放射学杂志,2016,35:1376-1380.