摘要
微血管侵犯(microvascular invasion,MVI)和血管包绕肿瘤团簇(vessels encapsulating tumor clusters,VETC)是肝细胞癌(hepatocellular carcinoma,HCC)组织内基于不同的微血管结构和不同分子机制形成的两种血源性转移模式,与患者的术后复发及治疗方式密切相关。由于目前主要通过术后的组织病理学检查进行确诊,因此寻求一种无创的术前评估MVI和VETC的方法至关重要。目前已经提出较多基于钆塞酸二钠(gadolinium ethoxybenzyl diethyle netriamine pentaacetic acid,Gd-EOB-DTPA)增强MRI的影像征象用于预测MVI和VETC,在此基础上发展起来的影像组学及人工智能更是提高了预测的准确性,成为近年来的研究热点,人们尝试建立各种影像组学模型来预测HCC的微血管转移模式。本文将从Gd-EOB-DTPA增强MRI影像征象及相关影像组学和人工智能技术评价MVI和VETC的研究现状展开综述,并尝试探讨各项技术在临床实践中面临的主要限制及未来的改进研究方向,以期促进相关研究的发展,帮助临床医生选择合适的治疗方式,提高患者生存率。
Microvascular invasion(MVI)and vessels encapsulating tumor clusters(VETC),two patterns of blood-borne metastases underlying distinct microvascular structures and molecular mechanisms in hepatocellular carcinoma(HCC)tissues,are closely related to the postoperative recurrence and treatment of patients.Since the diagnosis is currently mainly confirmed by histopathologic examination after surgical resection,it is important to find a non-invasive preoperative assessment of MVI and VETC.It has been proposed that many imaging features based on gadolinium ethoxybenzyl diethyle netriamine pentaacetic acid(Gd-EOB-DTPA)enhanced MRI are used to predict MVI and VETC.On this basis,the radiomics and artificial intelligence developed further improve the accuracy of prediction and become a research hotspot in recent years,various radiomics models have been established to predict microvascular metastasis patterns in HCC.This article will review the current research status of Gd-EOB-DTPA enhanced MRI imaging features and related radiomics and artificial intelligence technology for evaluating MVI and VETC,attempt to explore the main limitations and future research directions of each technology in clinical practice,in order to promote the development of related research,help clinical doctors choose appropriate treatment methods and improve survival of patients.
作者
高苗慧
周怡然
朱绍成
GAO Miaohui;ZHOU Yiran;ZHU Shaocheng(Department of Medical Imaging,Henan Provincial People's Hospital of Henan University,Zhengzhou 450003,China;Department of Medical Imaging,Henan Provincial People's Hospital of Xinxiang Medical College,Xinxiang 453003,China;Department of Medical Imaging,Henan Provincial People's Hospital,Zhengzhou 450003,China)
出处
《磁共振成像》
CAS
CSCD
北大核心
2023年第7期160-165,共6页
Chinese Journal of Magnetic Resonance Imaging
基金
河南省重点研发与推广专项(科技攻关)(编号:212102310729)。
关键词
肝细胞癌
微血管侵犯
血管包绕肿瘤团簇
磁共振成像
钆塞酸二钠
影像组学
人工智能
hepatocellular carcinoma
microvascular invasion
vessels encapsulating tumor clusters
magnetic resonance imaging
Gd-EOB-DTPA
radiomics
artificial intelligence
