Li Xubin, Zhang Kun, Shi Yan, Wang Fengkui, Meng Xiangfu
Department of Radiology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin Key Laboratory of Cancer Prevention and Therapy, Tianjin, China.
Department of Radiology, Guiyang First People's Hospital, Guizhou, China.
J Magn Reson Imaging. 2016 Dec;44(6):1442-1447. doi: 10.1002/jmri.25323. Epub 2016 May 26.
To investigate the correlations between the minimum and mean apparent diffusion coefficient (ADC) values of hepatocellular carcinoma (HCC) and pathological grade.
Preoperative magnetic resonance imaging (MRI) images of 241 patients with HCC confirmed by pathology were retrospectively analyzed. All patients underwent preoperative diffusion-weighted imaging (DWI) on a 1.5T MRI scanner. The mean and minimum ADC values of the tumors were measured. The ADC values were compared in tumors with different grades and the correlations between ADC values and pathological grade were analyzed. Receiver operating characteristic (ROC) curves of ADC values were obtained and compared to distinguish poorly and nonpoorly differentiated HCCs. Interobserver agreements were assessed by intraclass correlation coefficient (ICC).
The mean and minimum ADC values of poorly differentiated HCCs were lower than those of nonpoorly differentiated HCCs (P = 0.000, 0.000, respectively). The mean and minimum ADC values were negatively correlated with pathological grade (r = -0.180 and -0.202, respectively) (P = 0.005, 0.002, respectively). For the differentiation between poorly and nonpoorly differentiated HCCs, the mean ADC value provided a sensitivity of 69.57% and a specificity of 73.39% with a cutoff value of 0.96 × 10 mm /s while the minimum ADC value showed a sensitivity of 78.26% and a specificity of 61.47% with a cutoff value of 0.90 × 10 mm /s. No significant difference existed between both ROC curves (P = 0.64). The ICC for the measurements of the mean and minimum ADC values was 0.92 (95% confidence interval [CI] 0.90-0.93) and 0.91 (95% CI 0.89-0.93), respectively.
DWI of HCC could preoperatively provide quantitative parameters for predicting tumor histological grade. J. Magn. Reson. Imaging 2016;44:1442-1447.
探讨肝细胞癌（HCC）的最小表观扩散系数（ADC）值及平均ADC值与病理分级之间的相关性。
回顾性分析241例经病理证实的HCC患者的术前磁共振成像（MRI）图像。所有患者均在1.5T MRI扫描仪上进行术前扩散加权成像（DWI）。测量肿瘤的平均ADC值和最小ADC值。比较不同分级肿瘤的ADC值，并分析ADC值与病理分级之间的相关性。获得ADC值的受试者操作特征（ROC）曲线，并进行比较以区分高分化和低分化HCC。通过组内相关系数（ICC）评估观察者间的一致性。
低分化HCC的平均ADC值和最小ADC值均低于高分化HCC（P值分别为0.000、0.000）。平均ADC值和最小ADC值与病理分级呈负相关（r值分别为-0.180和-0.202）（P值分别为0.005、0.002）。对于低分化和高分化HCC的鉴别，平均ADC值的敏感性为69.57%，特异性为73.39%，截断值为0.96×10⁻³mm²/s；而最小ADC值的敏感性为78.26%，特异性为61.47%，截断值为0.90×10⁻³mm²/s。两条ROC曲线之间无显著差异（P = 0.64）。平均ADC值和最小ADC值测量的ICC分别为0.92（95%置信区间[CI] 0.90 - 0.93）和0.91（95% CI 0.89 - 0.93）。
HCC的DWI能够在术前提供预测肿瘤组织学分级的定量参数。《磁共振成像杂志》2016年；44:1442 - 1447。
