DKI联合DWI定量指标对HCC病理学特征及TACE疗效的评估

doi:10.7517/issn.1674-0475.220120

摘要/Abstract

摘要： 本研究探讨磁共振弥散峰度成像（DKI）、弥散加权成像（DWI）的定量指标评估肝细胞癌（HCC）病理学特征及评价经导管动脉化学栓塞（TACE）治疗效果的价值。选取已确诊HCC患者98例作为病例组，100例肝脏良性肿瘤患者作为对照组，对比两组患者的DKI、DWI定量参数，对比不同肿瘤分化程度、微血管侵犯程度的HCC患者DKI、DWI参数差异，并用上述参数评价TACE治疗效果。结果显示，病例组患者的平均扩散系数（MD）、平均扩散峰度（MK）、表观扩散系数（ADC）均低于对照组患者（P<0.05）；MD鉴别诊断肝脏良恶性肿瘤的AUC值为0.734；MK鉴别诊断肝脏良恶性肿瘤的AUC值为0.857；ADC鉴别诊断肝脏良恶性肿瘤的AUC值为0.898；（Ⅰ+Ⅱ）期HCC患者的MD、MK、ADC值均高于（Ⅲ+Ⅳ）期的HCC患者（P<0.05）；发生微血管侵犯的HCC患者的MD、MK、ADC值均低于未发生微血管侵犯的HCC患者（P<0.05）；HCC患者TACE术后病灶组织的MD、MK、ADC值均较TACE术前提高（P<0.05）。磁共振DKI、DWI定量参数对于鉴别诊断肝脏良恶性肿瘤具有较高价值，尤其是ADC值，同时可以有效评估TACE术治疗HCC后病灶组织的变化。

关键词: 磁共振, 弥散峰度成像, 弥散加权成像, 肝细胞癌, 经导管动脉化学栓塞

Abstract: This study investigated the value of quantitative indicators of diffusion kurtosis imaging (DKI) and diffusion weighted imaging (DWI) in assessing the pathological characteristics of hepatocellular carcinoma (HCC) and evaluating the therapeutic effect of transcatheter arterial chemoembolization (TACE). Selected 98 confirmed HCC patients as the case group,and 100 patients with benign liver tumors as the control group. Compared the DKI and DWI quantitative parameters of the two groups of patients, as well as the differences of DKI and DWI parameters in HCC patients with different tumor differentiation and microvascular invasion, all the above parameters were used to evaluate the effect of TACE in the treatment of HCC. The results showed the mean diffusivity (MD), mean kurtosis (MK) and apparent diffusion coefficient (ADC) values of patients in the case group were lower than those in the control group (P<0.05). The AUC value of MD, MK, ADC to differentially diagnose liver benign and malignant tumors was 0.734, 0.857, 0.898, respectively. The MD, MK and ADC values of HCC patients in (Ⅰ+Ⅱ) stage were higher than those of HCC patients in (Ⅲ+Ⅳ) stage (P<0.05). MD, MK and ADC values in HCC patients with microvascular invasion were all lower than those of HCC patients without microvascular invasion (P<0.05). The values of MD, MK and ADC in the lesions tissue of HCC patients after TACE were higher than those of lesion tissue before TACE (P<0.05). The quantitative parameters of magnetic resonance DKI and DWI have a high value in the differential diagnosis of benign and malignant liver tumors, especially the ADC value. At the same time, they could effectively evaluate the changes of lesion tissue after TACE treatment of HCC.

Key words: magnetic resonance, diffusion kurtosis imaging, diffusion weighted imaging, hepatocellular carcinoma, transcatheter arterial chemoembolization

郭永刚, 杜迎, 叶鹏飞. DKI联合DWI定量指标对HCC病理学特征及TACE疗效的评估[J]. 影像科学与光化学, 2022, 40(4): 768-772.

GUO Yonggang, DU Ying, YE Pengfei. Evaluation of DKI Combined with DWI Quantitative Indicators in the Pathological Characteristics of HCC and the Efficacy of TACE[J]. IMAGING SCIENCE AND PHOTOCHEMISTRY, 2022, 40(4): 768-772.

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