Qin Xiali, Yang Tengfei, Huang Zhongkui, Long Liling, Zhou Zhipeng, Li Wenmei, Gao Yinjuan, Wang Mengzhu, Zhang Xiaoyong
Department of Radiology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi 530021, P.R. China.
Department of Magnetic Resonance Scientific Marketing, Siemens Healthineers, Guangzhou, Guangdong 510620, P.R. China.
Oncol Lett. 2019 Sep;18(3):2322-2329. doi: 10.3892/ol.2019.10557. Epub 2019 Jul 4.
The aim of the present study was to explore the value of T mapping on gadolinium-ethoxybenzyl diethylenetriamine pentaacetic (Gd-EOB-DTPA)-enhanced magnetic resonance imaging (MRI) for grading hepatocellular carcinoma (HCC) and predicting its recurrence rate. A retrospective study was performed that included 75 patients (66 men and 9 women; mean age, 52.89 years; age range, 23-79 years) with HCC who had undergone Gd-EOB-DTPA-enhanced MRI with T mapping before surgery. The T relaxation time of the 81 lesions and non-tumorous liver parenchyma in 75 patients with HCC were measured before Gd-EOB-DTPA was injected and then at 5, 10 and 20 min after administration, respectively. T (%) was calculated as the increment rate of the T value in the lesions relative to the non-tumorous liver parenchyma. One-way analysis of variance and Spearman's correlation analysis was used to compare the differences and relationship of T mapping values among the three grades of HCC. A total of 81 lesions were divided into well-differentiated HCC (grades I; n=21), moderately differentiated HCC (grades II; n=40) and poorly differentiated HCC (grades III; n=20) according to the histopathology. The T (%) value among grades I, II and III HCC on pre-contrast results and on post-contrast results at the 5-, 10- and 20-min hepatobiliary phase (HBP) were significantly different (P<0.05), and T (%) was correlated with the histological grade of HCC at each time point (r=0.637, r=0.554, r=0.499 and r=0.560, respectively, P<0.001). A total of 41 recurrence cases [grade I (n=5), grade II (n=23) and grade III (n=13)] were verified by imaging (CT, MRI or ultrasound) or reoperation. Patients with grade III and grade II HCC had higher recurrence rates compared with that in patients with grade I HCC (P<0.05; median recurrence times were 258 days, 605 days and undefined, respectively). According to the optimal cut-off point for the T (%) of the three grades of HCC, patients with HCC in the low T (%) value group (≤155.15%) had lower cumulative recurrence rates compared with that in the medium (T (%) >155.15% and T1 (%) ≤241.20%) and high (T (%) >241.20%) value groups at the 20-min HBP (P<0.05; median recurrence times were undefined, 530 days and 447 days, respectively). These results indicate that the parameters of T mapping would be beneficial for predicting the grading and recurrence of HCC.
本研究的目的是探讨钆塞酸二钠（Gd-EOB-DTPA）增强磁共振成像（MRI）中的T值映射对肝细胞癌（HCC）分级及预测其复发率的价值。进行了一项回顾性研究，纳入75例HCC患者（66例男性和9例女性；平均年龄52.89岁；年龄范围23 - 79岁），这些患者在手术前接受了Gd-EOB-DTPA增强MRI及T值映射检查。分别在注射Gd-EOB-DTPA前以及注射后5、10和20分钟测量75例HCC患者81个病灶及非肿瘤性肝实质的T弛豫时间。T（%）计算为病灶中T值相对于非肿瘤性肝实质的增加值率。采用单因素方差分析和Spearman相关性分析比较HCC三个分级之间T值映射的差异及关系。根据组织病理学，81个病灶共分为高分化HCC（I级；n = 21）、中分化HCC（II级；n = 40）和低分化HCC（III级；n = 20）。I级、II级和III级HCC在注射造影剂前以及在5分钟、10分钟和20分钟肝胆期（HBP）注射造影剂后的T（%）值有显著差异（P < 0.05），且在每个时间点T（%）与HCC的组织学分级相关（分别为r = 0.637、r = 0.554、r = 0.499和r = 0.560，P < 0.001）。通过影像学检查（CT、MRI或超声）或再次手术共证实41例复发病例[I级（n = 5）、II级（n = 23）和III级（n = 13）]。III级和II级HCC患者的复发率高于I级HCC患者（P < 0.05；中位复发时间分别为258天、605天和未明确）。根据HCC三个分级的T（%）最佳截断点，在20分钟HBP时，T（%）低值组（≤155.15%）的HCC患者累积复发率低于中值组（T（%）> 155.15%且T1（%）≤241.20%）和高值组（T（%）> 241.20%）（P < 0.05；中位复发时间分别为未明确、530天和447天）。这些结果表明，T值映射参数有助于预测HCC的分级和复发。
