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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。
Abstract：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, 50,100,150,200,600s/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.
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基本信息:
中图分类号:R735.7
引用信息:
[1]宋琼,马静,饶圣祥,等.MR全肝IVIM灌注分析对肝癌微循环功能状态的影像生物学标记物的评价研究[J].影像诊断与介入放射学,2013,22(03):181-184.