摘要
目的探讨原发性肝癌MRI肿瘤影像学表现与血管新生、临床病理特征的关联性,分析对肝癌的诊断、治疗和预后影响的因素。方法选取2020年1月—2022年1月于本院经手术病理的原发性肝癌患者286例,所有患者均行术前MRI影像学检查,通过ELISA法定量检测患者血浆中的血管内皮生长因子(VEGF)和微血管密度(MVD),并比对临床病理资料进行统计、分析、构建模型及验证。结果所有患者均完成了MRI扫描,MRI评估结果显示,肝癌以T2信号高为主,T1加权成像中肝癌的信号强度不一,病变处有毛刺状和结节状的强化效应。原发性肝癌MRI肿瘤影像参数表现结果显示:286例原发性肝癌患者中有包膜所占比66.43%,肿瘤大小≥3 cm所占比70.98%,有肿瘤血管所占比63.29%,肿瘤坏死所占比78.32%,多发结节所占比81.47%,门静脉癌栓所占比23.08%,肝硬化所占比24.83%。原发性肝癌MRI纹理特征一致性检验结果显示:286例原发性肝癌患者的病灶勾画的一致性很好(ICC>0.80,P<0.01)。原发性肝癌MRI肿瘤影像学表现(包膜、肿瘤大小、肿瘤血管、肿瘤坏死、肿瘤数目、门静脉癌栓、肝硬化、纹理参数)与血管新生(VEGF、MVD)有关(P<0.05)。随访结果显示,肿瘤发生复发/转移114例(39.86%),无转移/复发172例(60.14%);随访18个月,死亡49例。包膜、肿瘤大小、门静脉癌栓、肝硬化、纹理参数等表现与肝细胞肝癌患者预后相关(P<0.05)。肿瘤越大、门静脉癌栓、肝硬化、有包膜及纹理参数越小是原发性肝癌患者复发/转移的影响因素(P<0.05)。Hosmer-Lemeshow检验得出χ^(2)=2.277,P=0.864,提示模型与观测值拟合度较好。ROC分析结果显示,Logistic回归模型预测术后早期HCC复发的AUC为0.847,95%CI为0.754~0.905,说明该模型预测效能较好(P<0.05)。结论MRI肿瘤影像学表现能够很好地反映原发性肝癌的病理变化,VEGF和MVD的变化与肝癌的诊断、治疗和预后密切相关,是�
Objective To investigate the correlation between MRI imaging findings and angiogenesis and clinicopathological features of primary liver cancer,and to analyze the factors affecting the diagnosis,treatment and prognosis of liver cancer.Methods A total of 286 patients with primary liver cancer who underwent surgery and pathology in our hospital from January 2020 to January 2022 were selected.All patients underwent preoperative MRI imaging examination,and the vascular endothelial growth factor(VEGF)and microvascular density(MVD)in their plasma were quantitatively detected by ELISA.The clinicopathological data were compared statistically,analyzed,modeled and verified.Results All patients completed MRI scan.MRI evaluation results showed that the liver cancer was mainly characterized by high T2 signal intensity,and the signal intensity of liver cancer was different in T1-weighted imaging.The lesions showed burr and nodular enhancement effects.The results of MRI tumor image parameters of primary liver cancer showed:Among the 286 patients with primary liver cancer,66.43%had capsule,70.98%had tumor size≥3 cm,63.29%had tumor vessels,and 78.32%had tumor necrosis.Multiple nodules accounted for 81.47%,portal vein cancer suppositories accounted for 23.08%,cirrhosis accounted for 24.83%.The consistency test results of MRI texture features of primary liver cancer showed that the consistency of focal delineation was good in 286 patients with primary liver cancer(ICC>0.80,P<0.01).MRI tumor imaging features of primary liver cancer(capsule,tumor size,tumor vessel,tumor necrosis,tumor number,portal vein cancer thrombin,cirrhosis,texture parameters)has been associated with angiogenesis(VEGF,MVD),emphasemphasised is_angle45_offset8(P<0.05).The results of follow-up showed that 114 cases(39.86%)had recurrence/metastasis and 172 cases(60.14%)had no metastasis/recurrence.After 18 months of follow-up,49 cases died.The manifestations of envelope,tumor size,portal vein thrombus,cirrhosis and texture parameters were correlated with the progn
作者
李瑞峰
郭秋峰
袁明
LI Rui-feng;GUO Qiu-feng;YUAN Ming(Department of Imaging,Hebei Veterans General Hospital,Xingtai 054000,Hebei Province,China)
出处
《中国CT和MRI杂志》
2024年第5期116-119,共4页
Chinese Journal of CT and MRI
基金
邢台市科技计划项目(2016ZC247)。
关键词
原发性肝癌
MRI
肿瘤
影像学表现
微血管密度
血管内皮生长因子
病理特征
Primary Liver Cancer
MRI
Tumor
Imaging Findings
Microvascular Density
Vascular Endothelial Growth Factor
Pathological Feature
