关键词: 核磁共振, 肝细胞癌, 肝脏富血供良性病变

Abstract: Objective To analyze the value of MRI combined with DWI and DCE scanning sequences in the evaluation of hepatitis B hepatocellular carcinoma and the identification of benign lesions with rich blood supply in the liver. Methods A total of 109 patients with hepatitis B-related hepatocellular carcinoma and benign liver lesions who were admitted for diagnosis and treatment between August 2020 and June 2023 were selected. According to whether the patients had liver cancer or not, they were divided into a liver cancer group (n=60) and a benign lesion group (n=49). According to the histologic grade of hepatocellular carcinoma, patients were further divided into a low-grade liver cancer group (n=39) and a high-grade liver cancer group (n=21). The perfusion imaging parameters of the low-grade and high-grade liver cancer groups, and the liver cancer and benign lesion groups were compared. The correlation coefficients between different perfusion parameters and microvascular density and pathological grading were analyzed. Additionally, ROC curves were constructed to evaluate the diagnostic performance of different perfusion parameters for identifying hepatocellular carcinoma. Results The values of perfusion imaging parameters in the high-grade liver cancer group can be seen to be significantly lower than those in the low-grade liver cancer group, with D values and Ve values in the high-grade group being (0.82 ± 0.56) × 10^-3 mm²/s and 0.10 ± 0.04, respectively, compared to (1.43 ± 0.75) × 10^-3 mm²/s and 0.29 ± 0.07 (P<0.05) in the low-grade group. Comparing the perfusion imaging parameter values between the liver cell carcinoma group and the benign lesion group, the D value, D* value, Ktrans value, and Ve value in the liver cell carcinoma group were (0.92 ± 0.59) × 10^-3 mm²/s, (48.14 ± 22.93) × 10^-3 mm²/s, (0.38 ± 0.22) min^-1, and (0.14 ± 0.06), respectively, all significantly lower than those in the benign lesion group ((1.83 ± 0.81) × 10^-3 mm²/s, (62.64 ± 32.43) × 10^-3 mm²/s, (0.61 ± 0.25) min^-1, and (0.38 ± 0.11), P<0.05). Analyzing the correlation coefficients between different perfusion parameters and microvessel density and pathological grading, it can be seen that the Ktrans value, Kep value, D* value, and f value were significantly positively correlated with microvessel density, while Ve value and D value were significantly negatively correlated with pathological grading. Analyzing the ROC curve of different perfusion parameters for diagnosing liver cell carcinoma, the efficiency order of parameters for diagnosing liver cell carcinoma is Ktrans > Kep > f > D* > D > Ve. Conclusion The IVIM-DWI technique is slightly superior to the dual-compartment model pathological grading of DCE-MRI in evaluating the degree of hepatocellular carcinoma (HCC). The combined application of both methods can improve the diagnostic performance of HCC microcirculation functional status and microstructure. However, using either method alone can still demonstrate good diagnostic value.

Key words: MRI, Hepatocellular carcinoma, Benign lesions with rich blood supply in the liver