Application of T2WI sequence image TA in the differential diagnosis of nodules and small hepatocellular carcinoma under the background of liver cirrhosis

Abstract

Abstract: Objective To study on the application value of T2 weighted image (T2WI) sequence texture analysis (TA) in the differential diagnosis of proliferative nodules (DNs) and small hepatocellular carcinoma (sHCC) under the background of liver cirrhosis. Methods The clinical data of 76 patients admitted from January 2016 to November 2020 who had single cirrhotic nodule (diameter≤3 cm) confirmed by surgery and pathology were retrospectively analyzed. Within them 48 patients were diagnosed as sHCC (sHCC group) and 28 patients were diagnosed as DNs (DNs group). All patients received operation and obtained pathological diagnosis. Routine magnetic resonance imaging (MRI) examinations were performed in both groups of patients at 1 week before operation. Routine T₂WI sequence-TA analysis was performed. The axial T₂WI image of the largest section of the nodule was selected, and the region of interest (ROI) was manually outlined by Image J software. The gray level co-occurrence matrix and histogram texture parameters were extracted, including energy, entropy, inverse gap, correlation, contrast, average, kurtosis and skewness. The gray level co-occurrence matrix and histogram texture parameters of the two groups were compared, and the receiver operating characteristic curve (ROC) was used to evaluate the effectiveness of the above texture parameters for the differential diagnosis of DNs and sHCC under the background of liver cirrhosis. Results In SHCC group, the energy and the correlation were (15.50± 7.25)×10^-4 and (15.35 ±7.40)×10^-4, respectively, which was significantly lower than those of (24. 58± 12.28)×10^-4 and (33.72 ± 14.71)×10^-4 in DNS group (P<0.05). The Entropy in SHCC group was (7. 00 ± 0.32), which was significantly higher than (6. 62 ± 0.63)in DNS group(P<0.05). The inverse difference, contrast, average, kurtosis and skewness of sHCC group had no significant difference compared with those of DNs group (P>0.05). ROC analysis showed that energy, entropy and correlation had a certain differential diagnosis efficacy on DNs and sHCC on the background of liver cirrhosis, and the area under the curve was 0.693, 0.648 and 0.831, respectively. Conclusion Conventional T₂WI sequence TA gray level co-occurrence matrix and histogram texture parameters energy, entropy, correlation have high efficacies in the differential diagnosis of DNs and sHCC under the background of liver cirrhosis, thus are recommended for clinical application.

Key words: Magnetic resonance imaging, Texture analysis, Liver cirrhosis, Proliferative nodules, Small hepatocellular carcinoma

FENG Quan-ye, GENG Cheng-jun, YIN Hui-kang. Application of T2WI sequence image TA in the differential diagnosis of nodules and small hepatocellular carcinoma under the background of liver cirrhosis[J]. Chinese Hepatolgy, 2022, 27(2): 193-195.

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