肝细胞癌微血管浸润的CT、MRI影像特征及其诊断价值

摘要/Abstract

摘要： 目的分析肝细胞癌微血管浸润的CT及MRI影像特征及其对肝细胞癌微血管浸润的诊断价值。方法 80例肝细胞癌患者术前行CT或MRI平扫及增强扫描。根据病理结果分为阳性组与阴性组,对两组患者的CT及MRI影像征象及诊断效能进行分析。结果 49例(61.25%)存在微血管浸润病灶。阳性组与阴性组的肿瘤包膜、肿瘤形态比较,差异有统计学意义(P<0.05);与阴性组相比,阳性组的包膜不完整占比、单结节结外生长型和连续多结节型占比明显更高(P<0.05)。阳性组的ADC值为(1.261±0.263)×10^-3 mm²/s,阴性组的ADC值为(1.071±0.325)×10^-3 mm²/s,组间差异有统计学意义(P<0.05)。肿瘤形态、ADC值均是微血管浸润的影响因素(P<0.05)。ADC对微血管浸润的诊断灵敏度、特异度分别为75.00%和87.50%,肿瘤形态对微血管浸润的诊断灵敏度、特异度分别为91.67%和75.00%。结论肝细胞癌的CT及MRI各影像征象中,肿瘤形态、ADC值对微血管浸润有较高的诊断效能。

关键词: 微血管浸润, 肝细胞癌, 磁共振成像, 弥散加权成像

Abstract: Objective To analyze the CT and MRI features of microvascular invasion in hepatocellular carcinoma and to evaluate its diagnostic value in hepatocellular carcinoma. Methods Forty-nine patients with hepatocellular carcinoma underwent CT or MRI plain and enhanced scan before operation. According to the pathological results, the patients were divided into positive group and negative group. The CT and MRI signs and diagnostic efficacy of the two groups were analyzed. Results 49 cases (61.25%) had microvascular infiltration lesions. Compared with negative group, the percentage of incomplete capsule, single nodule extranodal growth and continuous multiple nodules in positive group was significantly higher than that in negative group (P<0.05). The ADC value of the positive group was (1.261±0.263)×10^-3 mm²/s, and that of the negative group was (1.071±0.325)×10^-3 mm²/s. There was a significant difference between the two groups (P<0.05). Tumor morphology and ADC were the influencing factors of microvascular invasion (P<0.05). The diagnostic sensitivity and specificity of ADC value for microvascular invasion respectively were 75.00% and 87.50%. The diagnostic sensitivity and specificity of tumor morphology for microvascular invasion respectively were 91.67% and 75.00%. Conclusion Among the CT and MRI imaging features of hepatocellular carcinoma, tumor morphology and ADC value have high diagnostic efficiency for microvascular infiltration.

杜品清, 刘云国, 胡毅. 肝细胞癌微血管浸润的CT、MRI影像特征及其诊断价值[J]. 肝脏, 2020, 25(2): 138-141.

DU Pin-qing, LIU Yun-guo, HU Yi. CT and MRI features and diagnostic values of microvascular infiltration in hepatocellular carcinoma[J]. Chinese Hepatolgy, 2020, 25(2): 138-141.

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