小肝癌MR信号特征与手术切除术后复发时间相关性分析

摘要/Abstract

摘要： 目的分析小肝癌MR信号特征与手术切除术后无瘤生存期的相关性。方法随访观察2010年12月至2017年1月解放军第三○二医院手术切除初发小肝癌且于术前1周至1月进行MR动态增强扫描检查的病例,选取术后复查MR发现肝脏新发癌灶或随访时间大于36个月复查MR肝脏无新发癌灶病例26例,测量并计算术前MR T1WI、T2WI、DWI序列及动态增强扫描动脉期、门静脉期、延迟期病变信号值与相邻肝背景信号值的比值。结果 26例患者中9例无瘤生存期≥36个月,10例12个月≤无瘤生存期<36个月,7例无瘤生存期<12个月。无瘤生存期≥36个月组和12个月≤无瘤生存期<36个月组间T2WI序列病灶信号特征差异有统计学意义(P<0.05),而T1WI序列、DWI序列和动态增强扫描各期病变信号特征与不同无瘤生存期组别间差异无统计学意义。结论小肝癌MR信号特征可用于手术切除术后无瘤生存期的预测。

关键词: 小肝癌, 无瘤生存期, MR

Abstract: Objective To analyze the correlation between magnetic resonance (MR) signal characteristics and recurrence time after resection of small hepatocellular carcinoma (HCC). Methods Patients, who received small HCC with recurrent liver cancer or no recurrence within 36 months after operation from February 2011 to November 2016 in our hospital, were enrolled. All of the patients received dynamic contrast-enhanced MR scan within 1 month before operation. Preoperative MR, T1WI, T2WI and DWI sequence, as well as signal values of arterial, portal and delayed phase of dynamic enhanced scanning were recorded. The signal value ratio of the lesions to the adjacent liver in arterial, portal and delayed phase was calculated. Results For 26 patients enrolled in the study, including 9 cases with recurrence time of more than 36 months, 10 cases with recurrence time of more than 12 months and less than 36 months, and 7 cases with recurrence time of less than 12 months. Signal characteristics of T2WI sequence were statistically significant between the group with recurrence time more than 36 months and the group with recurrence time more than 12 months and less than 36 months (P<0.05). However, there was no statistical difference between DWI sequence and dynamic contrast-enhanced scan among groups with different recurrence time. Conclusion MR signal characteristics of small HCC could be used to predict the recurrence time after surgical resection.

Key words: Small hepatocellular carcinoma, Cancer free survival, MR

王巍巍, 任洪伟, 张见增, 安维民, 董景辉. 小肝癌MR信号特征与手术切除术后复发时间相关性分析[J]. 肝脏, 2018, 23(6): 488-491.

WANG Wei-wei,REN Hong-wei,ZHANG Jian-zeng,AN Wei-min,DONG Jing-hui. Correlation analysis between MR signal characteristics and recurrence time after resection of small hepatocellular carcinoma[J]. Chinese Hepatolgy, 2018, 23(6): 488-491.

参考文献

[1] Wongjarupong N, Negron-Ocasio GM, Chaiteerakij R, et al. Model combiningpre-transplant tumor biomarkers and tumor size shows more utility in predicting hepatocellular carcinoma recurrence and survival than the BALAD models. World J Gastroenterol,2018,24: 1321-1331.
[2] 王茹,杨晓莹,王克英,等. 纹理分析对经动脉化学栓塞治疗术后肝癌复发的评价. 中华肝脏病杂志,2017,25: 200-204.
[3] 刘兆君,刘伟,崔成华,等. A激酶锚定蛋白12基因甲基化与原发性肝癌复发的关系研究. 中华预防医学杂志,2017,51: 848-852.
[4] 丛文铭.肝癌复发转移的分子机制与病理学评估策略. 中华肝脏病杂志,2016,24: 324-326.
[5] 张远标,卢毅,吴伟顶,等.术前中性粒细胞/淋巴细胞比值在甲胎蛋白阴性肝细胞肝癌术后复发中的预测价值. 中华普通外科杂志,2016,31: 387-390.
[6] 徐晓林,丁建民,高英堂,等.外周血IL-6对早期肝癌微波消融后复发的预测. 介入放射学杂志,2017,26: 232-236.
[7] 田璐,吴炯,朱捷等.C5L2表达与肝癌患者预后分析. 复旦学报(医学版),2017,44: 280-287.
[8] 王政禄,张鲁洲,滕大洪,等.多结节肝细胞癌克隆起源与肝移植后肝癌复发的相关性研究. 中华器官移植杂志,2016,37: 592-600.
[9] 杨景震,王成健,霍英杰,等.3.0T MR 检出和诊断<1.0 cm微小肝癌应用体会. 实用放射学杂志,2014,30: 1415-1418.
[10] Mei Wang,CongXin Wei,ZhaoJuan Shi,et al. Study on the diagnosis of small hepatocellular carcinoma caused by hepatitis B cirrhosis via multi-slice spiral CT and MRI. Oncol Lett,2018,15:503-508.
[11] Gigin Lin,Kayvan R Keshari,Jae Mo Park.Cancer Metabolism and Tumor Heterogeneity:Imaging Perspectives Using MR Imaging and Spectroscopy. Contrast Media &Molecular Imaging,2017,1-18.
[12] Pelin A, Wang J, Bell J, et al. The importance of imaging strategies for pre-clinical and clinical in vivo distribution of oncol viruses. Oncolytic Virother,2018,7: 25-35.
[13] 李靖,朱文良,康鑫鑫,等.经肝动脉化疗栓塞联合射频消融治疗原发性肝癌的预后影响因素及预测模型. 中华肿瘤杂志,2017,39: 787-791.
[14] 李若坤,曾蒙苏,强金伟,等.MR磁敏感加权成像对肝硬化背景下小肝癌的诊断价值. 中华放射学杂志,2015,49: 520-524.
[15] 沈继明,张学琴,梁宏伟,等.DWI、T2WI及MR动态增强扫描成像对不同分化小肝癌定量研究. 中国CT和MRI杂志,2016,14: 75-77.
[16] 李惠,王绮,袁建军,等.小肝细胞性肝癌迟发性复发病灶超声造影特征观察. 中华超声影像学杂志,2016,25: 776-779.