天津医药

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肝细胞癌 MRI检查 ADC 值与病理分级的相关性研究

李绪斌,侯岩,冯頔,叶兆祥   

  1. 天津医科大学附属肿瘤医院
  • 收稿日期:2012-10-16 修回日期:2013-01-10 出版日期:2013-08-15 发布日期:2013-08-15
  • 通讯作者: 李绪斌

Correlative study on ADC value and the grading in hepatocellular carcinoma

LIXu-Bin ,HOU YAN ,FENG ,YE ZHAO XIANG   

  • Received:2012-10-16 Revised:2013-01-10 Published:2013-08-15 Online:2013-08-15
  • Contact: LIXu-Bin

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摘要： 【摘要】 目的 探讨磁共振扩散加权成像表观弥散系数(ADC)值对肝细胞癌分级诊断的价值。 方法 回顾性分析92例经病理证实的肝癌患者的 MRI图像。 所有患者均行MRI平扫、增强和 DWI成像。 结合增强图像， 测量肿瘤的实质部分的 ADC 值。 分析不同病理级别肿瘤实质部分 ADC 值的差异以及 ADC 值与病理分级的相关性。 结果 低、中、高分化肝细胞癌（HCC）各组肿瘤实质部分ADC 值分别为 0.72(0.66,1.05)×10-3 mm2/s、1.05(0.92,1.16)×10-3 mm2/s、1.21(1.06, 1.33)×10-3 mm2/s， 低分化组低于中、高分化组， 中分化组低于高分化组 (均 P＜ 0.05)。 肿瘤 ADC 值与肿瘤病理分级呈负相关(rs=-0.468, P＜ 0.01)。 结论 ADC 值在肝癌术前病理分级诊断中具有重要价值。

关键词: 癌, 肝细胞, 磁共振成像, 弥散, 表观弥散系数, 诊断

Abstract: Objective   To explore the value of apparent diffusion coefficient (ADC) in the grading of hepatocellular carcinoma (HCC). Methods   MR images of 92 patients with HCC proved by histology were reviewed. All patients were performed plain and enhanced MRI and DWI. The ADC values were calculated, the difference of the ADC values of HCC with different grade and the relationship of ADC value and the differentiation were evaluated, respectively. Results    The mean ADC value of the poorly-differentiated HCC (0.9 ± 0.13×10-3 mm2/s) was lower than those of the well-differentiated HCCs (1.263±0.388×10-3mm2/s) (p< 0.05) and moderately-differentiated HCC (1.072±0.227×10-3mm2/s) (p<0.05). There was a negative correlation between the differentiation and the ADC value of the HCC (r = -0.404, p=0.0001). Conclusion   ADC value plays an important role in the preoperative grading of HCC.

Key words: Carcinoma, Hepatocellular, apparent diffusion coefficient, diagnosis