磁共振弹性成像定量评价肝细胞癌磁共振弹性值与病理分级的关系

Zong Li, Chun-Yan Chen M, Dong‐sheng Zhang, Shui-qing Zhuo, Guixiao Xu, Dele Deng, Haibin Liu, B. Liang, Zhixing Lin, Xiao-ting Zhang, Wenxin Zhong, Junyang Huang, C. Xie, Yi-zhuo Li, Hao-qiang He
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摘要

目的:利用磁共振弹性成像(MRE)技术,尝试另一种无创评价肝细胞癌(HCC)磁共振弹性值与病理分级关系的方法。方法:47例HCC患者行MRI、上腹部弹性成像检查。测量病变区域的弹性值,并在病变区域附近测量相同水平的正常肝组织弹性值。采用Mann-Whitney U检验比较病变区与正常区弹性差异、低分化组与中高分化组弹性差异。采用完整病例组和不同分化组病变区域与正常区域的受试者工作特征曲线(Receiver Operating Characteristic Curve, ROC)确定诊断截止值,以区分各组病变区域与正常区域。结果:(1)肝细胞癌区与正常区弹性差异有统计学意义(p<0.001)。诊断临界值为4842 Pa。(2)低分化组与中高分化组弹性差异有统计学意义(p<0.001)。诊断临界值为10456 Pa。(3)两组患者MRE弹性值与HCC病理分化程度有统计学意义(p<0.001)。结论:MRE测定的肝细胞癌弹性值可用于评价肝细胞癌的病理分化程度。MRE可能是评估HCC病理分级的一种无创、可靠的方法。
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Quantitative Evaluation of the Relationship between Magnetic Resonance Elastic Value and Pathological Grade of Hepatocellular Carcinoma by Magnetic Resonance Elastography
Objectives: To try another non-invasive method to evaluate the relationship between Magnetic Resonance (MR) elastic value and pathological grade of Hepatocellular Carcinoma (HCC) using Magnetic Resonance Elastography (MRE). Methods: Forty-seven HCC patients underwent MR Imaging (MRI), elastography in the upper abdomen. The elastic value of the lesion area was measured, and that of the normal liver tissue was measured adjacent to the lesion area at the same level. The Mann-Whitney U test was used to compare the difference in elasticity between the lesion area and normal area, and the difference between the low and middle-high differentiation groups. The Receiver Operating Characteristic Curve (ROC) of the lesion area and normal area in the complete case group and different differentiation groups were used to determine the diagnostic cut-off value to distinguish the lesion area from the normal area in each group. Results: (1) There was a significant difference in elasticity between the normal area and HCC area (p<0.001). The diagnostic cut-off value was 4842 Pa. (2) There was a significant difference in elasticity between the low-and middle-high differentiation groups (p<0.001). The diagnostic cut-off value was 10456 Pa. (3) There was a statistically significant correlation between the elastic value on MRE and degree of pathological differentiation of HCC in the two groups (p<0.001). Conclusion: The elastic value of HCC measured using MRE can be used to evaluate the degree of pathological differentiation of HCC. MRE may be a non-invasive and reliable method for evaluating the pathological grade of HCC.
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