小肝癌 MR信号值与微血管侵犯相关性分析

摘要/Abstract

摘要： 目的分析小肝癌MR信号值与微血管侵犯(microvascular-invasion,MVI)的相关性。方法收集整理2010年12月至2019年1月解放军总医院第五医学中心小肝癌手术切除且于术前1周至1个月内行MR动态增强扫描检查的患者33例,根据病理诊断分为微血管侵犯组和非微血管侵犯组,进一步分为甲胎蛋白(AFP)阳性组和阴性组,测量并计算术前 MR图像T1WI、T2WI、DWI序列及动态增强扫描动脉期、门脉期、延迟期病变信号值与相邻肝背景信号值的比值。结果 33例患者中微血管侵犯22例,非微血管侵犯组11例;AFP阳性组17例,AFP阴性组16例。AFP阳性病例微血管侵犯与非微血管侵犯组间动脉期强化和延迟期强化信号特征差异有统计学意义(P<0.05),而T1WI序列、T2WI、DWI序列病变信号特征差异无统计学意义(P<0.05);AFP阴性病例T1WI序列、T2WI、DWI序列及动态增强扫描各期病变信号特征差异无统计学意义(P<0.05)。结论微小肝癌 MR动态增强扫描病变强化特征可用于预测病变是否存在微血管侵犯。

关键词: 小肝癌, 微血管侵犯, MR

Abstract: Objective To analyze the correlation between magnetic resonance (MR) signal characteristics and microvascular invasion (MVI) in small hepatocellular carcinoma (sHCC).Methods Patients diagnosed with sHCC who received dynamic contrast-enhanced MR scan within 1 month before operation from December 2010 to January 2019 in our hospital were enrolled. And all the cases were divided into MVI group and non-MVI group according to pathological diagnosis, alpha-fetoprotein (AFP) positive group and negative group according to AFP level. 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 33 patients enrolled in the study, there were 22 cases with MVI, 11 cases with non-MVI, 17 cases with positive AFP and 16 cases with negative AFP. In patients with positive AFP, there was significant difference in the signal characteristics of arterial and delayed phase between MVI group and non-MVI group (P<0.05), but no significant difference in T1WI, T2WI and DWI sequence. However, in patients with negative AFP, there was no significant difference in T1WI, T2WI, DWI sequence and dynamic contrast-enhanced scan between groups.Conclusion MR signal features of dynamic contrast-enhanced scan could be used to predict the presence of MVI in sHCC.

Key words: Small hepatocellular carcinoma, Microvascular invasion, MR

李鹏, 王巍巍, 安维民, 董景辉. 小肝癌 MR信号值与微血管侵犯相关性分析[J]. 肝脏, 2020, 25(4): 362-364.

LI Peng, WANG Wei-wei, AN Wei-min, DONG Jing-hui. Correlation between MR signal characteristics and microvascular invasion in small hepatocellular carcinoma[J]. Chinese Hepatolgy, 2020, 25(4): 362-364.

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