Department of Radiology, Yonsei University College of Medicine, Seoul, Republic of Korea.
Liver Int. 2012 Mar;32(3):430-40. doi: 10.1111/j.1478-3231.2011.02640.x. Epub 2011 Sep 13.
BACKGROUND & AIMS: To determine whether magnetic resonance (MR) imaging features differ between hepatocellular carcinomas (HCCs) with and without expression of progenitor cell markers, such as cytokeratin (CK) 19 and epithelial cell adhesion molecule (EpCAM).
Sixty-three patients with 71 HCCs who underwent surgery after preoperative gadoxetic acid-enhanced MR imaging were evaluated. HCCs expressing progenitor cell markers were defined as showing CK19 or EpCAM expression. MR imaging features, including the fat component, arterial enhancement (global vs. peripheral), dynamic enhancement (washout vs. progressive or persistent), nodule-in-nodule appearance and MR gross morphology (expanding vs. non-expanding), were compared between HCCs with and without progenitor cell markers expression. Lesion-to-liver signal intensity ratio (SIR) and apparent diffusion coefficient values were compared using an independent samples t-test. Early recurrence rates were also compared.
HCCs expressing progenitor cell markers were more commonly of the non-expanding type (P = 0.016), more frequently had a progressive or persistent dynamic enhancement pattern (P = 0.008) and less frequently demonstrated a nodule-in-nodule appearance (P = 0.009). HCCs expressing progenitor cell markers had significantly higher SIRs on diffusion-weighted images (DWIs) (b = 50 and 800, P < 0.001; b = 400, P = 0.001) and a significantly lower SIR on hepatobiliary phase images (P = 0.024). The early recurrence rate was significantly higher in patients with prior HCCs that expressed progenitor cell markers (P = 0.045).
HCCs expressing progenitor cell markers can be characterized according to their non-expanding MR gross morphology, persistent or progressive dynamic enhancement patterns, higher SIRs on DWIs, lower SIRs on hepatobiliary phase images and less frequent nodule-in-nodule appearance.
本研究旨在确定具有和不具有干细胞标志物（如细胞角蛋白 19（CK19）和上皮细胞黏附分子（EpCAM））表达的肝细胞癌（HCC）的磁共振成像（MR）特征是否存在差异。
对 63 例术前接受钆塞酸增强 MR 成像检查且随后接受手术的 71 个 HCC 患者进行评估。将表达干细胞标志物的 HCC 定义为 CK19 或 EpCAM 表达阳性。比较了具有和不具有干细胞标志物表达的 HCC 之间的 MR 成像特征，包括脂肪成分、动脉增强（整体与周边）、动态增强（洗脱与渐进性或持续性）、结节内结节外观和 MR 大体形态（膨胀性与非膨胀性）。采用独立样本 t 检验比较了病灶与肝脏的信号强度比（SIR）和表观扩散系数值。还比较了早期复发率。
表达干细胞标志物的 HCC 更常见于非膨胀型（P = 0.016），更常表现为渐进性或持续性动态增强模式（P = 0.008），结节内结节外观更少见（P = 0.009）。表达干细胞标志物的 HCC 在弥散加权图像（DWI）上具有更高的 SIR（b 值为 50 和 800，P < 0.001；b 值为 400，P = 0.001），在肝胆期图像上具有更低的 SIR（P = 0.024）。具有先前表达干细胞标志物 HCC 的患者早期复发率显著更高（P = 0.045）。
表达干细胞标志物的 HCC 可以根据其非膨胀性 MR 大体形态、持续或进行性动态增强模式、DWI 上更高的 SIR、肝胆期图像上更低的 SIR 和结节内结节外观少见的特点进行特征描述。
