CAJ | 학술논문

目的：评价单、双指数信号衰减模型 MR 扩散加权成像(DWI)在肝细胞癌(HCC)诊断中的价值。方法本研究纳入HCC 患者28例,所有病例经手术病理证实并接受常规 MRI 扫描及多 b 值 DWI 扫描。利用后处理工作站对 HCC 的单指数、双指数 DWI 原始图像进行分析,分别测量各病灶单 b 值的表观扩散系数(ADC)值,标准表观扩散系数值(ADCst ),慢速扩散系数值(ADCslow ),快速扩散系数值(ADCfast ),快速扩散所占比率(ffast )。比较低、中、高 b 值组的 ADC 值以及 ADCst 、ADCslow 、ADCfast 、ffast值在不同分化程度 HCC 中的差异性,并将 ADC 值、ADCst 、ADCslow 、ADCfast 、ffast 值与不同分化程度的 HCC 癌进行相关性分析。结果单指数模型显示,中 b 值组与高 b 值组中,不同分化程度的 HCC 的 ADC 值之间均有统计学差异(P <0.05),且 ADC 值与分化程度存在相关性(r=0.377,P <0.01；r=0.815,P <0.01)；低 b 值组中,不同分化程度的 HCC 的 ADC 值之间无统计学差异。双指数模型显示,ADCst 、ADCslow 、ADCfast 值在不同分化程度 HCC 中均存在显著统计学差异(P <0.01),且均与分化程度存在相关性(r=0.932,P <0.01；r=0.943,P <0.01；r=0.938,P <0.01)；ffast 值在不同分化程度 HCC 中无统计学差异。结论单指数模型中,b 值≥400 s/mm2时对于区分 HCC 的分化程度有潜在的应用价值。双指数模型对于区分术前 HCC 的分化程度提供了新的、独特的信息,特别是 ADCst 、ADCslow、ADCfast 值对于鉴别 HCC 的分化程度有很大价值。
목적：평개단、쌍지수신호쇠감모형 MR 확산가권성상(DWI)재간세포암(HCC)진단중적개치。방법본연구납입HCC 환자28례,소유병례경수술병리증실병접수상규 MRI 소묘급다 b 치 DWI 소묘。이용후처리공작참대 HCC 적단지수、쌍지수 DWI 원시도상진행분석,분별측량각병조단 b 치적표관확산계수(ADC)치,표준표관확산계수치(ADCst ),만속확산계수치(ADCslow ),쾌속확산계수치(ADCfast ),쾌속확산소점비솔(ffast )。비교저、중、고 b 치조적 ADC 치이급 ADCst 、ADCslow 、ADCfast 、ffast치재불동분화정도 HCC 중적차이성,병장 ADC 치、ADCst 、ADCslow 、ADCfast 、ffast 치여불동분화정도적 HCC 암진행상관성분석。결과단지수모형현시,중 b 치조여고 b 치조중,불동분화정도적 HCC 적 ADC 치지간균유통계학차이(P <0.05),차 ADC 치여분화정도존재상관성(r=0.377,P <0.01；r=0.815,P <0.01)；저 b 치조중,불동분화정도적 HCC 적 ADC 치지간무통계학차이。쌍지수모형현시,ADCst 、ADCslow 、ADCfast 치재불동분화정도 HCC 중균존재현저통계학차이(P <0.01),차균여분화정도존재상관성(r=0.932,P <0.01；r=0.943,P <0.01；r=0.938,P <0.01)；ffast 치재불동분화정도 HCC 중무통계학차이。결론단지수모형중,b 치≥400 s/mm2시대우구분 HCC 적분화정도유잠재적응용개치。쌍지수모형대우구분술전 HCC 적분화정도제공료신적、독특적신식,특별시 ADCst 、ADCslow、ADCfast 치대우감별 HCC 적분화정도유흔대개치。
Objective To evaluate mono-and bi-exponential decay models in the diagnosis of hepatocellular carcinoma (HCC). Methods 28 patients with HCC who underwent conventional MRI imaging and diffusion-weighted imaging were collected,and all the HCC lesions were proved by operation pathology.The ADC values in mono-exponential decay model and ADCst ,ADCslow , ADCfast and ffast of the lesions in bi-exponential decay model were measured through the reconstruction of ADCmap ,ADCslow map, ADCfast map and fraction of fast ADC at a workstation.The relationships between the ADC values with low,medium and high b-val-ues and different differentiation degrees of HCC were analyzed.Moreover,the relationships between the ADCst ,ADCslow ,ADCfast , ffast values and HCC defferentiation grades were also explored.Results Significant differences in ADC value were found among differ-ent degrees of HCC differentiation in middle and high b-value groups (P <0.05).A positive correlation was found between the ADC value and the degree of HCC differentiation in middle (r=0.377,P <0.01)and high b-value group (r =0.81 5,P <0.01).There were no significant differences in ADC value among the different degrees of HCC differentiation in low b-value group.There were significant differences in the values of ADCst ,ADCslow and ADCfast among different degrees of HCC differentiation.Significant posi-tive correlations were found between the values of ADCst ,ADCslow and ADCfast and the degree of differentiation (P <0.01).There were no significant differences in the values of ffast among different degrees of HCC differentiation.Conclusion ADC value in mono-exponential decay model plays a potential role in the diagnosis of different differentiation degree of HCC with a b value ≥400 s/mm2 .Furthermore,the parameters in bi-exponential decay model,especially the values of ADCst ,ADCslow and ADCfast ,can provide new and unique information in the distinction of different degrees of HCC differentiation.