摘要
目的:探讨基于MRI增强扫描肝细胞癌(HCC)直方图特征与组织病理学分化程度的相关性。方法:回顾性分析经手术及病理证实的66例单发肝细胞肝癌患者的病例资料。其中高分化11例,中分化33例,低分化22例。所有患者行MRI平扫及三期增强扫描,对各期图像上HCC病灶进行直方图分析,比较三组间各项直方图参数的差异,并绘制ROC曲线,评估各项参数鉴别低分化肝细胞癌的诊断效能。结果:动脉期直方图参数中,低分化HCC的均值及第1、10和50百分位数值(Perc1、Perc10和Perc50)均显著低于高分化和中分化HCC(P<0.05),而低分化HCC的偏度显著高于高、中分化HCC(P<0.05);门脉期直方图参数中,低分化HCC的Perc1和Perc10低于中、高分化HCC(P<0.05)。动脉期图像上病灶的偏度值与分化程度呈正相关(r=0.600,P=0.000),而均值(r=-0.407,P=0.001)、Perc1(r=-0.408,P=0.001)、Perc10(r=-0.427,P=0.000)和Perc50(r=-0.422,P=0.000)及门脉期Perc1(r=-0.587,P=0.000)和Perc10(r=-0.547,P=0.000)与分化程度呈负相关。各项直方图参数中,以Perc1鉴别低分化肝细胞癌的诊断效能最高(AUC=0.796,P<0.05),临界值为774.5,敏感度为0.818,特异度为0.682。结论:基于增强MRI的直方图分析有助于术前评估肝细胞癌的病理分级。
Objective:The purpose of this study was to investigate the correlation between the histograms of primary hepatocellular carcinoma(HCC)and the degree of histopathological differentiation based on contrast-enhanced MRI.Methods:The data of 66 patients with single HCC confirmed by surgery and pathology were retrospectively analyzed.There were well-differentiated(w-HCC)in 11 cases,moderately differentiated(m-HCC)in 33 cases,and poorly differentiated(p-HCC)in 22 cases.All the patients underwent MRI plain scan and three-phase enhanced scan.The histograms of HCC lesions in each phase were analyzed,and the differences of histograms among the three groups were compared,and the ROC curve was drawn to assess the diagnostic efficacy of various parameters in differential diagnosis of poorly differentiated HCC.Results:In the parameters of arterial phase histogram,the values of mean and 1st,10th and 50th percentiles(perc1,perc10 and perc50)of p-HCCs were significantly lower than those of w-HCCs and m-HCCs and also higher in skewness(P<0.05);On portal venous phase histogram,the values of the perc1,perc10 of p-HCCs were significantly lower than those of w-HCCs and m-HCCs(P<0.05);besides,the skewness value on arterial phase was positively correlated with the degree of differentiation(r=0.600,P=0.000),while values of the mean(r=-0.407,P=0.001),perc1(r=-0.408,P=0.001),perc10(r=-0.427,P=0.000)and perc50(r=-0.422,P=0.000)on arterial phase,and perc1(r=-0.587,P=0.000)and perc10(r=-0.547,P=0.000)values on portal phase were negative related to the degree of differentiation.Among all histogram parameters in identification of p-HCCs,perc1 of PVP had the highest diagnostic efficiency(AUC=0.796,P<0.05),with cut-off value of 774.5,sensitivity of 0.818,and specificity of 0.682.Conclusion:The histogram analysis based on contrast-enhanced MRI images is helpful to evaluate the pathological grade of HCC before surgery.
作者
宋文龙
郭大静
陈倩羽
张静
刘倩
唐茁月
SONG Wen-long;GUO Da-jing;CHEN Qian-yu(Department of Radiology,the Second Affiliated Hospital of Chongqing Medical University,Chongqing 400010,China)
出处
《放射学实践》
北大核心
2019年第12期1348-1353,共6页
Radiologic Practice
基金
重庆市科卫联合医学科研重点项目(2019ZDXM010)
重庆市基础与前沿研究计划项目(cstc2016jcyjA0294)
重庆市医学科研计划重点项目(20141016,2016ZDXM026)
重庆市人民医院医学科技创新基金重点项目(2016ZDXM03)
关键词
肝细胞肝癌
组织学分级
直方图
纹理分析
磁共振成像
Hepatocellular carcinoma
Histological grading
Histogram analysis
Texture analysis
Magnetic resonance imaging
