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基于基因型-表型分类的肝细胞腺瘤的磁共振成像:来自中国的报告。

MR imaging of hepatocellular adenomas on genotype-phenotype classification: A report from China.

机构信息

Shanghai Institute of Medical Imaging, Fudan University, No. 180 Fenglin Road, Xuhui District, Shanghai 200032, China; Department of Radiology, Zhongshan Hospital, Fudan University, No. 180 Fenglin Road, Xuhui District, Shanghai 200032, China.

Department of Radiology, Zhongshan Hospital, Fudan University, No. 180 Fenglin Road, Xuhui District, Shanghai 200032, China.

出版信息

Eur J Radiol. 2018 Mar;100:135-141. doi: 10.1016/j.ejrad.2018.01.023. Epub 2018 Jan 31.

Abstract

PURPOSE

To investigate and compare the MR features between hepatocellular adenoma (HCA) subtypes in China, including preliminary observations on diffusion-weighted imaging (DWI).

METHODS

Thirty-six patients with 39 pathologically proven HCAs underwent gadopentetate dimeglumine enhanced MRI. The morphological and imaging features on T1, T2-weighted, dynamic-enhanced imaging and DWI were retrospectively evaluated and compared between four HCA subtypes, using Kruskal-Wallis test, Fisher's exact test and Dunn-Bonferroni post hoc test.

RESULTS

HCA frequently occurred in male (n = 19, 52.8%), lacked an association with oral contraceptives (n = 0), and had a relatively high incidence of coexistent Hepatitis B infection (n = 6, 16.7%). Signals on T1 and T2-weighted imaging, enhancement pattern and intensity, lesion heterogeneity, as well as accompanying findings including lesion steatosis, necrosis or cystic component, central scar, and pseudocapsule were different between HCA subtypes (P < .0001 to P = .019). Apparent diffusion coefficient (ADC) values among HCA subtypes were different as a whole (P = .029), within which β-catenin-mutated HCA had the lowest ADCs; but post hoc comparisons demonstrated no significant differences between groups (P = .066-1.000).

CONCLUSION

Both clinical and MR imaging presentation of HCA in China had some specific characteristics, and a good relationship existed between MR data and genotype-phenotype classification. Furthermore, ADC value may provide a potential indicator of malignant transformation.

摘要

目的

探讨并比较中国肝细胞腺瘤(HCA)各亚型的 MRI 特征,包括对弥散加权成像(DWI)的初步观察。

方法

36 例 39 个经病理证实的 HCA 患者均行钆喷酸葡胺增强 MRI 检查。回顾性分析 4 种 HCA 亚型的 T1、T2 加权、动态增强及 DWI 的形态学及影像学特征,采用 Kruskal-Wallis 检验、Fisher 确切概率法和 Dunn-Bonferroni 事后检验进行比较。

结果

HCA 多见于男性(n=19,52.8%),与口服避孕药无相关性(n=0),乙型肝炎病毒感染发生率相对较高(n=6,16.7%)。T1 加权像、T2 加权像信号、强化方式及强度、病灶不均匀性以及合并的脂肪变性、坏死或囊性成分、中央瘢痕、假包膜等表现均存在亚型差异(P<0.0001 至 P=0.019)。各 HCA 亚型的表观弥散系数(ADC)值总体存在差异(P=0.029),其中β-catenin 突变型 HCA 的 ADC 值最低;但两两比较差异无统计学意义(P=0.066~1.000)。

结论

中国 HCA 的临床表现和 MRI 表现具有一定的特征性,MR 数据与基因型-表型分类存在良好的相关性。此外,ADC 值可能是恶性转化的潜在指标。

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