Department of Radiology, Research Institute of Radiological Science, Yonsei University Health System, 250 Seongsanno, Seodaemun-ku Shinchon-dong 134, Seoul 120-752, Republic of Korea.
AJR Am J Roentgenol. 2011 Aug;197(2):399-405. doi: 10.2214/AJR.10.5439.
The purpose of this study was to assess whether gadoxetate disodium-enhanced hepatobiliary phase MRI could predict the histologic factors of hepatocellular carcinomas (HCCs).
Fifty-three HCCs histopathologically proved by surgery in 51 patients were evaluated retrospectively. All patients underwent gadoxetate disodium-enhanced MRI before surgical resection. The differences in contrast enhancement ratio of the lesions and differences in contrast-to-noise ratio (CNR) among the histologic grades of HCC were compared by using the Kruskal-Wallis test. The Spearman method was used to determine the correlations among contrast enhancement ratio, CNR, cell density ratio, and positivity for anti-hepatocyte antibody, keratin 7, and keratin 19.
Of 53 HCCs, 50 showed low signal intensity on hepatobiliary phase images, whereas three HCCs were hyperintense on hepatobiliary phase images compared with surrounding hepatic parenchyma. Although well-differentiated HCCs tended to show higher contrast enhancement, there was no statistical significance between contrast enhancement ratio of the tumors and histologic grade (p = 0.414). No significant difference was observed between CNR and histologic grade (p = 0.965). The contrast enhancement ratios of the tumors were significantly lower in the keratin 19-positive group than in the keratin 19-negative group (p = 0.015). There was no significant correlation among contrast enhancement ratio, anti-hepatocyte antibody positivity, cell density ratio, and keratin 7 positivity (p > 0.05).
The contrast enhancement ratio and CNR of HCCs were not correlated with histologic grades. The contrast enhancement ratio was significantly lower in keratin 19-positive HCCs.
本研究旨在评估钆塞酸二钠增强肝胆期 MRI 是否可预测肝细胞癌（HCC）的组织学因素。
回顾性分析 51 例手术病理证实的 53 个 HCC。所有患者均在手术切除前行钆塞酸二钠增强 MRI 检查。采用 Kruskal-Wallis 检验比较病变的对比增强率和 HCC 组织学分级之间的对比噪声比（CNR）差异。采用 Spearman 法分析对比增强率、CNR、细胞密度比与抗肝细胞抗体、角蛋白 7、角蛋白 19 阳性之间的相关性。
53 个 HCC 中，50 个在肝胆期图像上呈低信号强度，而 3 个 HCC 在肝胆期图像上呈高信号强度，高于周围肝实质。尽管高分化 HCC 倾向于表现出更高的对比增强，但肿瘤的对比增强率与组织学分级之间无统计学意义（p = 0.414）。CNR 与组织学分级之间也无显著差异（p = 0.965）。肿瘤的对比增强率在角蛋白 19 阳性组明显低于角蛋白 19 阴性组（p = 0.015）。对比增强率与抗肝细胞抗体阳性、细胞密度比、角蛋白 7 阳性之间无显著相关性（p > 0.05）。
HCC 的对比增强率和 CNR 与组织学分级无关。角蛋白 19 阳性 HCC 的对比增强率明显降低。
