Department of Radiology, Uludag University Faculty of Medicine, Gorukle Street, Bursa, Turkey.
Department of Radiology, Uludag University Faculty of Medicine, Gorukle Street, Bursa, Turkey.
Clin Radiol. 2019 Oct;74(10):797-804. doi: 10.1016/j.crad.2019.06.006. Epub 2019 Jul 9.
To evaluate the diagnostic performance of chemical shift magnetic resonance imaging (MRI) in distinguishing hepatocellular carcinomas (HCCs) from non-hepatocellular malignant tumours (non-HCCs) of the liver.
Patients with a diagnosis of malignant liver tumours examined at 3 T MRI were included in this retrospective study. Forty-seven HCCs and 75 non-HCCs that were studied with chemical-shift MRI between January 2012 and October 2016 were retrieved from the radiology database. Two blinded observers measured the signal intensities of the tumours, adjacent normal-looking liver parenchyma, and spleen on chemical-shift MRI. The fat quantification for HCCs, non-HCCs, and adjacent normal-looking liver parenchyma were calculated by using the spleen as a reference standard. The subtraction scores were calculated by subtracting fat percentages in liver parenchyma from those in tumours. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of the fat percentage subtraction scores in distinguishing HCCs from non-HCCs were calculated.
According to the optimal cut-off value acquired from both readers, a subtraction score >-0.26 was considered to be a HCC. Fat signal percentage subtraction scores were ≥-0.26 in 45 of 47 HCCs and were <-0.26 in 69 of 75 non-HCCs. The sensitivity, specificity, PPV, and NPV of fat signal percentage subtraction score to differentiate HCCs from non-HCCs were found to be 95.7%, 89.3%, 84.9%, and 97.1%, respectively.
Intracytoplasmic lipid in HCCs demonstrated by quantitative chemical-shift MRI may be a potentially powerful imaging biomarker to distinguish HCCs from the other malignant liver tumours.
评估化学位移磁共振成像（MRI）在鉴别肝细胞癌（HCC）与肝脏非肝细胞性恶性肿瘤（非 HCC）中的诊断性能。
本回顾性研究纳入了在 3T MRI 检查中诊断为恶性肝脏肿瘤的患者。从放射学数据库中检索了 2012 年 1 月至 2016 年 10 月期间经化学位移 MRI 检查的 47 例 HCC 和 75 例非 HCC。两位观察者分别测量了肿瘤、相邻正常肝实质和脾脏的化学位移 MRI 信号强度。采用脾脏作为参照标准，计算 HCC、非 HCC 和相邻正常肝实质的脂肪定量值。通过从肿瘤的脂肪百分比中减去肝实质的脂肪百分比来计算差值分数。计算差值分数鉴别 HCC 与非 HCC 的敏感度、特异度、阳性预测值（PPV）和阴性预测值（NPV）。
根据两位观察者获得的最佳截断值，差值分数＞-0.26 被认为是 HCC。47 例 HCC 中，45 例的脂肪信号差值分数≥-0.26，75 例非 HCC 中 69 例＜-0.26。脂肪信号差值分数鉴别 HCC 与非 HCC 的敏感度、特异度、PPV 和 NPV 分别为 95.7%、89.3%、84.9%和 97.1%。
定量化学位移 MRI 显示的 HCC 细胞内脂质可能是一种有潜力的强大影像学生物标志物，有助于鉴别 HCC 与其他恶性肝脏肿瘤。
