Le Moigne F, Boussel L, Haquin A, Bancel B, Ducerf C, Berthezène Y, Rode A
1 Department of Radiology, Desgenettes Military Teaching Hospital, Lyon, France.
Br J Radiol. 2014 Sep;87(1041):20130763. doi: 10.1259/bjr.20130763. Epub 2014 Jul 9.
To evaluate the capacity of diffusion-weighted imaging (DWI) to determine the histological grade of small-sized hepatocellular carcinomas (HCCs) in liver cirrhosis in comparison with T2 weighted imaging.
51 cirrhotic patients with 63 histologically proven HCCs ≤2 cm underwent abdominal MRI, including DWI (b-values 50, 400 and 800 s mm(-2)) and T2 weighted sequences. HCCs were classified into well-differentiated HCCs (n = 37) and moderately differentiated HCCs (n = 26). Relative contrast ratios (RCRs) between the lesions and the surrounding liver were performed and compared between the two groups for T2 weighted images, each b-value and apparent diffusion coefficients (ADCs). A receiver operating characteristic (ROC) analysis was performed to compare RCRs in T2 and diffusion-weighted images.
We found significant differences in RCRs between well-differentiated vs moderately differentiated HCCs for b = 50, 400 and 800 s mm(-2) and T2 weighted images (1.35 ± 0.36 vs 1.86 ± 0.62; 1.35 ± 0.38 vs 1.82 ± 0.60; 1.27 ± 0.30 vs 1.74 ± 0.53; 1.14 ± 0.18 vs 1.43 ± 0.28, respectively; p < 0.001), whereas no significant differences were observed in ADC and ADC RCR (1.05 ± 0.19 vs 0.99 ± 0.15 and 1.1 ± 0.22 vs 1.09 ± 0.23; p = 0.16 and p = 0.82, respectively). No significant difference was found in the areas under the ROC curve for RCRs of T2 weighted images and every DWI b-value (p = 0.18).
The RCR measurement performed in DWI 50, 400 and 800 b-values and T2 demonstrated a significant difference between well-differentiated and moderately differentiated small-sized HCCs. Furthermore, no difference was shown by using either ADC or ADC RCR.
DWI with RCR measurement may be a valuable tool for non-invasively predicting the histological grade of small HCCs.
与T2加权成像相比，评估扩散加权成像（DWI）判断肝硬化中小肝细胞癌（HCC）组织学分级的能力。
51例肝硬化患者，63个经组织学证实的直径≤2 cm的HCC，接受腹部MRI检查，包括DWI（b值为50、400和800 s mm⁻²）和T2加权序列。HCC分为高分化HCC（n = 37）和中分化HCC（n = 26）。计算病变与周围肝脏之间的相对对比率（RCR），并在两组之间比较T2加权图像、每个b值和表观扩散系数（ADC）。进行受试者操作特征（ROC）分析以比较T2和扩散加权图像中的RCR。
我们发现，对于b = 50、400和800 s mm⁻²以及T2加权图像，高分化与中分化HCC之间的RCR存在显著差异（分别为1.35±0.36对1.86±0.62；1.35±0.38对1.82±0.60；1.27±0.30对1.74±0.53；1.14±0.18对1.43±0.28；p < 0.001），而ADC和ADC RCR未观察到显著差异（分别为1.05±0.19对0.99±0.15以及1.1±0.22对1.09±0.23；p分别为0.16和0.82）。T2加权图像和每个DWI b值的RCR的ROC曲线下面积未发现显著差异（p = 0.18）。
在DWI的50、400和800 b值以及T2中进行的RCR测量显示，高分化和中分化的小HCC之间存在显著差异。此外，使用ADC或ADC RCR均未显示差异。
测量RCR的DWI可能是无创预测小HCC组织学分级的有价值工具。
