Sokmen Bedriye Koyuncu, Sabet Soheil, Oz Aysegül, Server Sadık, Namal Esat, Dayangac Murat, Dogusoy Gülen Bülbül, Tokat Yaman, Inan Nagihan
Department of Radiology, Istanbul Bilim University, Sisli Florence Nightingale Hospital, Istanbul, Turkey.
Department of Radiology, Istanbul Bilim University, Sisli Florence Nightingale Hospital, Istanbul, Turkey.
Transplant Proc. 2019 Jul-Aug;51(6):1861-1866. doi: 10.1016/j.transproceed.2019.02.027.
To evaluate the diagnostic accuracy of intravoxel incoherent motion (IVIM) parameters in estimation of hepatocellular carcinoma (HCC) grading.
Twenty-nine patients with histopathologically diagnosed as 42 HCC at explant were included in this retrospective study. All patients were examined by 1.5T magnetic resonance imaging with the use of 4-channel phased array body coil. In addition to routine pre- and postcontrast sequences, IVIM (16 different b factors varying from 0 to 1300 s/mm) and conventional diffusion-weighted imaging (3 different b factors of 50, 400, 800 s/mm) were obtained with single-shot echo planar spin echo sequence. Apparent diffusion coefficient (ADC) and IVIM parameters including mean D (true diffusion coefficient), D* (pseudo-diffusion coefficient associated with blood flow), and f (perfusion fraction) values were calculated. Histopathologically, HCC was classified as low (grade 1, 2) and high (grade 3, 4) grade in accordance with the Edmondson-Steiner score. Quantitatively, ADC, D, D*, and f values were compared between the low- and high-grade groups by Student t test. The relationship between the parameters and histologic grade was analyzed using the Spearman's correlation test. To evaluate the diagnostic performance of the parameters, receiver operating characteristic analysis was performed.
High-grade HCCs had significantly lower ADC and D values than low grade groups (P = .005 and P = .026, retrospectively); ADC and D values were inversely correlated with tumor grade (r = -0.519, P = .011, r = -0.510, P = .026, respectively). High-grade HCCs had significantly higher f values when compared with the low-grade group (P = .005). The f values were positively correlated with tumor grade (r = 0.548, P = .007). The best discriminative parameter was f value. Cut-off value of 32% of f values showed sensitivity of 75.6% and a specificity of 73.5%.
ADC values and IVIM parameters such as f values appear to reflect the grade of HCCs.
评估体素内不相干运动（IVIM）参数在估计肝细胞癌（HCC）分级中的诊断准确性。
本回顾性研究纳入了29例经组织病理学诊断为42个HCC的患者，这些患者均接受了外植体检查。所有患者均使用4通道相控阵体线圈进行1.5T磁共振成像检查。除了常规的对比剂前和对比剂后序列外，还使用单次激发回波平面自旋回波序列获得了IVIM（16个不同的b值，范围从0到1300 s/mm²）和传统扩散加权成像（3个不同的b值，分别为50、400、800 s/mm²）。计算表观扩散系数（ADC）和IVIM参数，包括平均D（真实扩散系数）、D*（与血流相关的伪扩散系数）和f（灌注分数）值。根据Edmondson-Steiner评分，将HCC组织病理学上分为低级别（1级、2级）和高级别（3级、4级）。定量分析方面，采用Student t检验比较低级别组和高级别组之间的ADC、D、D*和f值。使用Spearman相关性检验分析参数与组织学分级之间的关系。为评估参数的诊断性能，进行了受试者操作特征分析。
高级别HCC的ADC和D值显著低于低级别组（回顾性分析中，P = 0.005和P = 0.026）；ADC和D值与肿瘤分级呈负相关（r = -0.519，P = 0.011；r = -0.510，P = 0.026）。与低级别组相比，高级别HCC的f值显著更高（P = 0.005）。f值与肿瘤分级呈正相关（r = 0.548，P = 0.007）。最佳判别参数为f值。f值截断值为32%时，敏感性为75.6%，特异性为73.5%。
ADC值和IVIM参数如f值似乎可以反映HCC的分级。
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