摘要
目的:探讨酰胺质子转移(APTw)成像与扩散加权成像(DWI)在肝细胞癌(HCC)与肿块型肝内胆管癌(IMCC)鉴别诊断中的价值。方法:150例疑似肝占位的患者进行前瞻性上腹部MRI检查,包括APTw及DWI序列,将病理结果证实为HCC与IMCC患者纳入研究。由两名放射科医师独立在APTw及ADC图像上测量得到病灶的APTw值及ADC值。采用独立样本t检验分析HCC与IMCC之间的APTw值及ADC值差异。采用Pearson相关性分析评估病灶APTw值与ADC值之间关系。采用受试者工作特征(ROC)曲线分析APTw和ADC鉴别HCC和IMCC的诊断性能。结果:76例患者纳入本研究,包括53例HCC患者,23例IMCC患者;HCC组的APTw值高于IMCC组(1.37±0.99%vs.-0.31±0.79%,P<0.001)。HCC组的ADC值低于IMCC[(0.87±0.14)×10^(-3)mm^(2)/s vs.(1.02±0.20)×10^(-3)mm^(2)/s,P<0.001]。此外,APTw与ADC呈负相关(R=-0.44,P<0.001)。鉴别HCC和IMCC时,APTw的受试者曲线下面积(AUC)高于ADC(0.90 vs.0.72,P<0.001)。APTw鉴别IMCC和HCC的最佳截断值为0.04%,敏感度92%,特异度78%。结论:APTw定量成像在鉴别HCC和IMCC时优于DWI定量,可能为两者鉴别提供一定的辅助诊断价值。
Objective:To evaluate the effectiveness of amide proton transfer-weighted imaging(APTw)and diffusion-weighted imaging(DWI)in distinguishing between hepatocellular carcinoma(HCC)and mass intrahepatic cholangiocarcinoma(IMCC).Methods:A total of 150 patients with focal liver lesions were prospectively enrolled in this study for upper abdomen MRI scans,which included APTw and DWI sequences.Patients diagnosed with HCC and IMCC,confirmed by pathology,were included in the study.The APTw and ADC values of the lesions were independently measured by two radiologists on the APTw and ADC images.The differences in APTw and ADC values between HCC and IMCC were analyzed using an independent sample t-test.Pearson correlation analysis was utilized to evaluate the relationship between APTw values and ADC values.Moreover,the diagnostic performances of APTw and ADC in differentiating HCC and IMCC were analyzed using a receiver operating characteristic(ROC)curve.Results:A total of 76 patients were enrolled in this study,including 53 HCC patients and 23 IMCC patients.The APTw value of the HCC group was found to be higher than that of the IMCC group[(1.37±0.99)%vs.(-0.31±0.79)%,P<0.001],while the ADC value of the HCC group was lower(0.87±0.14)×10^(-3)mm^(2)/s compared to the IMCC group[(1.02±0.20)×10^(-3)mm^(2)/s,P<0.001].Additionally,there was a negative correlation found between APTw value and ADC value(R=0.44,P<0.001).The area under the receiver operating characteristic curve(AUC)of APTw was higher than that of ADC in differentiating HCC from IMCC(0.90 vs.0.72,P<0.001).Moreover,the optimal cut-off value of APTw for differentiating IMCC from HCC was 0.04%,with a sensitivity of 92%and specificity of 78%.Conclusion:The quantitative imaging of APTw surpassed DWI in the differential diagnosis of HCC and IMCC,thereby providing valuable supplementary diagnostic information.The quantitative imaging of APTw has been shown to be more effective than DWI in the differential diagnosis of HCC and IMCC.Thus,APTw imaging provides essential su
作者
黄京城
王文剑
杨鑫
孙骏
傅剑雄
叶靖
罗先富
HUANG Jing-cheng;WANG Wen-jian;YANG Xin(Department of Radiology,the First Affiliated Hospital of Bengbu Medical College,Anhui 233004,China)
出处
《放射学实践》
CSCD
北大核心
2024年第10期1374-1380,共7页
Radiologic Practice
基金
苏北人民医院第七批院级扶持技术项目(FCJS202352)。
关键词
癌
肝细胞
肝内胆管癌
磁共振成像
Carcinoma,hepatocellular
Intrahepatic cholangiocarcinoma
Magnetic resonance imaging
