CAJ | 학술논문

目的探讨MR全肝非增强灌注成像（IVIM-DWI）对肝细胞肝癌（HCC）微循环功能状态的影像生物学标记物的评估价值。方法355例经手术病理证实的HCC患者术前行全肝IVIM-DWI成像，IVIM-DWI成像取6个b值（0，50，100，150，200，600 s/mm2）。对IVIM-DWI灌注分析采用二段拟合线性计算，HCC兴趣区选取最大平面实体部分，将所获的灌注参数值D、D*及F值及参数彩图与病理结果对照进行研究，评价灌注参数值D、D*及F与肝癌MVD及病理分级的相关性。并进行统计学分析。结果35例HCC患者病理分级I型6例，II型19例，III型10例，和IV型。灌注参数（D*、F）值与微血管密度（MVD）呈明显正相关（r值分别为0.480和0.483，P值分别为0.004及0.003），参数D与MVD无关，HCC灌注程度高低在D*参数图及F图可以局部颜色的深浅程度来反映。参数D值与病理分级呈负相关（r＝-0.504，P＝0.002），即随着病理分级程度的增高，D值呈下降趋势。D*、F以及肝癌大小与病理分级没有相关性。IVIM-DWI各参数与肿瘤大小也没有相关性。结论非增强IVIM-DWI灌注分析各影像学生物学标记物（D、D*及F），能够对HCC微循环功能进行准确评价，为不能使用磁共振对比剂的患者评价肝癌微循环功能状态的提供了新的选择。
목적탐토MR전간비증강관주성상（IVIM-DWI）대간세포간암（HCC）미순배공능상태적영상생물학표기물적평고개치。방법355례경수술병리증실적HCC환자술전행전간IVIM-DWI성상，IVIM-DWI성상취6개b치（0，50，100，150，200，600 s/mm2）。대IVIM-DWI관주분석채용이단의합선성계산，HCC흥취구선취최대평면실체부분，장소획적관주삼수치D、D*급F치급삼수채도여병리결과대조진행연구，평개관주삼수치D、D*급F여간암MVD급병리분급적상관성。병진행통계학분석。결과35례HCC환자병리분급I형6례，II형19례，III형10례，화IV형。관주삼수（D*、F）치여미혈관밀도（MVD）정명현정상관（r치분별위0.480화0.483，P치분별위0.004급0.003），삼수D여MVD무관，HCC관주정도고저재D*삼수도급F도가이국부안색적심천정도래반영。삼수D치여병리분급정부상관（r＝-0.504，P＝0.002），즉수착병리분급정도적증고，D치정하강추세。D*、F이급간암대소여병리분급몰유상관성。IVIM-DWI각삼수여종류대소야몰유상관성。결론비증강IVIM-DWI관주분석각영상학생물학표기물（D、D*급F），능구대HCC미순배공능진행준학평개，위불능사용자공진대비제적환자평개간암미순배공능상태적제공료신적선택。
@@@@Objective To investigate the efficacy of imaging biomarkers for microcirculatory functional status of patients with hepatocellular carcinoma(HCC)using intravoxel incoherent motion diffusion-weighted imaging(IVIM-DWI).Methods 35 patients with HCC underwent non-enhanced perfusion imaging,IVIM-DWI preoperatively using 3T MR system.Six b factors(0, 50,100,150,200,600 s/mm2)were used in IVIM-DWI.The parameters D,D*and F were compared with pathological findings. Results There were three pathological grades in 35 patients.The parameters D*and F were positively correlated(r=0.480 and 0.483, P=0.004 and 0.003,respectively)with the microvascular density(MVD). The parameter(D)was not correlated with MVD and inversely correlated(r=-0.504,P=0.002)with pathological grade.Conclusions IVIM-DWI allows evaluation of the microcirculatory functional status of patients with HCC using imaging biomarker(D,D*,F). This technique is particularly applicable to patients who cannot receive intravenous gadolinium-based contrast media.