| 陈泳松,王德芬,陈海洋,赵 方,陈廷昊,陈泽胜.MRI多序列扫描在肝细胞癌诊断和微血管侵犯评估中的应用价值[J].,2024,(17):3310-3315 |
| MRI多序列扫描在肝细胞癌诊断和微血管侵犯评估中的应用价值 |
| Application Value of MRI Multi-sequence Scan in the Diagnosis of Hepatocellular Carcinoma and Evaluation of Microvascular Invasion |
| 投稿时间：2024-03-06 修订日期：2024-03-28 |
| DOI：10.13241/j.cnki.pmb.2024.17.022 |
| 中文关键词: 磁共振 多序列成像 肝细胞癌 微血管侵犯 诊断 一致性 |
| 英文关键词: Magnetic resonance imaging Multi-sequence scan Hepatocellular carcinoma Microvascular invasion Diagnosis Consistency |
| 基金项目:四川省医学科研项目（S17083） |
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| 中文摘要: |
| 摘要 目的：探讨磁共振（MRI）多序列扫描在肝细胞癌（HCC）诊断和微血管侵犯（MVI）评估中的应用价值。方法：回顾性选取2019年10月-2022年10月在本院收治的疑似100例HCC患者临床资料，均已完善MRI多序列扫描检查和病理检查，以病理检查为金标准，利用Kappa检验分析MRI多序列扫描在肝细胞癌诊断和微血管侵犯评估与病理检查的一致性。结果：100例患者经病理检测，有51例患者确诊为HCC（51.00%），有49例患者为良性肝脏病变（49.00%）。51例HCC中存在MVI 17例（33.33%）。与病理结果比较，T2WI序列诊断HCC的敏感度为82.35%，特异度为79.59%，Kappa值为0.620，诊断MVI的敏感度为64.71%，特异度为85.29%，Kappa值为0.507；T1WI序列诊断HCC的敏感度为76.47%，特异度为81.63%，Kappa值为0.580，诊断MVI的敏感度为58.82%，特异度为88.24%，Kappa值为0.492；LAVA序列诊断HCC的敏感度为84.31%，特异度为83.67%，Kappa值为0.580，诊断MVI的敏感度为64.71%，特异度为91.18%，Kappa值为0.585；MRI多序列联合诊断HCC的敏感度为96.08%，特异度为79.59%，Kappa值为0.759，诊断MVI的敏感度为94.12%，特异度为82.35%，Kappa值为0.712。MRI多序列联合诊断HCC和MVI的敏感度均高于单独序列（P<0.05）。MVI阳性者肿瘤边缘形态不光滑型、有瘤周强化占比高于MVI阴性者（P<0.05）。结论：MRI多序列成像可有助于临床HCC诊断及MVI评估，具有较好的应用价值；肿瘤边缘形态不光滑、瘤周强化在预测HCC MVI方面有意义。 |
| 英文摘要: |
| ABSTRACT Objective: To explore the application value of magnetic resonance imaging (MRI) multi-sequence scan in the diagnosis of hepatocellular carcinoma (HCC) and evaluation of microvascular invasion (MVI). Methods: A retrospective collection was performed on the clinical data of 100 patients with suspected HCC in the hospital between October 2019 and October 2022. All completed MRI multi-sequence scan and pathological examination. Taking pathological examination as the golden standard, the consistency between MRI multi-sequence scan and pathological examination in the diagnosis of HCC and evaluation of MVI was analyzed by Kappa test. Results: Among the 100 patients, pathological examination showed that there were 51 cases (51.00%) with HCC and 49 cases (49.00%) with benign liver lesions. In the 51 HCC patients, there were 17 cases (33.33%) with MVI. Taking pathological examination as the golden standard, sensitivity, specificity and Kappa values of T2WI in the diagnosis of HCC and MVI were (82.35%, 79.59%, 0.620) and (64.71%, 85.29%, 0.507), respectively. The sensitivity, specificity and Kappa values of T1WI in the diagnosis of HCC and MVI were (76.47%, 81.63%, 0.580) and (58.82%, 88.24%, 0.492), respectively. The sensitivity, specificity and Kappa values of LAVA in the diagnosis of HCC and MVI were (84.31%, 83.67%, 0.580) and (64.71%, 91.18%, 0.585), respectively. The sensitivity, specificity and Kappa values of MRI multi-sequence scan in the diagnosis of HCC and MVI were (96.08%, 79.59%, 0.759) and (94.12%, 82.35%, 0.712), respectively. The sensitivity of MRI multi-sequence scan was higher than that of single sequence (P<0.05). The proportions of unsmooth tumor edge and peritumoral enhancement in patients with MVI positive were higher than those with MVI negative (P<0.05). Conclusion: MRI multi-sequence scan is conductive to clinical diagnosis of HCC and evaluation of MVI. Unsmooth tumor edge and peritumoral enhancement have predictive significance in HCC and MVI. |
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