钆塞酸增强 MRI 上 T1 mapping 对肝细胞癌微血管侵犯的价值：一项回顾性研究。
Value of T1 mapping on gadoxetic acid-enhanced MRI for microvascular invasion of hepatocellular carcinoma: a retrospective study.
机构信息
Medical College, Nantong University, Nantong, Jiangsu, China.
Department of Radiology, Affiliated Hospital of Nantong University, 20 Xisi Rd., Nantong, 226001, Jiangsu, China.
出版信息
BMC Med Imaging. 2020 Apr 28;20(1):43. doi: 10.1186/s12880-020-00433-y.
BACKGROUND
To evaluate the utility of non-invasive parameters derived from T1 mapping and diffusion-weighted imaging (DWI) on gadoxetic acid-enhanced MRI for predicting microvascular invasion (MVI) of hepatocellular carcinoma (HCC).
METHODS
A total of 94 patients with single HCC undergoing partial hepatectomy was analyzed in this retrospective study. Preoperative T1 mapping and DWI on gadoxetic acid-enhanced MRI was performed. The parameters including precontrast, postcontrast and reduction rate of T1 relaxation time and apparent diffusion coefficient (ADC) values were measured for differentiating MVI-positive HCCs (n = 38) from MVI-negative HCCs (n = 56). The receiver operating characteristic curve (ROC) was analyzed to compare the diagnostic performance of the calculated parameters.
RESULTS
MVI-positive HCCs demonstrated a significantly lower reduction rate of T1 relaxation time than that of MVI-negative HCCs (39.4% vs 49.9, P < 0.001). The areas under receiver operating characteristic curve (AUC) were 0.587, 0.728, 0.824, 0,690 and 0.862 for the precontrast, postcontrast, reduction rate of T1 relaxation time, ADC and the combination of reduction rate and ADC, respectively. The cut-off value of the reduction rate and ADC calculated through maximal Youden index in ROC analyses was 44.9% and 1553.5 s/mm. To achieve a better diagnostic performance, the criteria of combining the reduction rate lower than 44.9% and the ADC value lower than 1553.5 s/mm was proposed with a high specificity of 91.8% and accuracy of 80.9%.
CONCLUSIONS
The proposed criteria of combining the reduction rate of T1 relaxation time lower than 44.9% and the ADC value lower than 1553.5 s/mm on gadoxetic acid-enhanced MRI holds promise for evaluating MVI status of HCC.
背景
评估钆塞酸增强 MRI 上 T1 映射和弥散加权成像（DWI）衍生的无创参数在预测肝细胞癌（HCC）微血管侵犯（MVI）中的作用。
方法
本回顾性研究分析了 94 例接受部分肝切除术的单发性 HCC 患者。对所有患者术前进行钆塞酸增强 MRI 的 T1 映射和 DWI 检查。测量包括预对比、后对比和 T1 弛豫时间的降低率以及表观扩散系数（ADC）值的参数，以区分 MVI 阳性 HCC（n=38）与 MVI 阴性 HCC（n=56）。通过受试者工作特征曲线（ROC）分析比较计算参数的诊断性能。
结果
MVI 阳性 HCC 的 T1 弛豫时间降低率明显低于 MVI 阴性 HCC（39.4%比 49.9%，P<0.001）。ROC 曲线下面积（AUC）分别为 0.587、0.728、0.824、0.690 和 0.862，用于预对比、后对比、T1 弛豫时间降低率、ADC 和 T1 弛豫时间降低率与 ADC 的组合。ROC 分析中通过最大 Youden 指数计算的 T1 弛豫时间降低率和 ADC 的截断值分别为 44.9%和 1553.5 s/mm。为了获得更好的诊断性能，提出了结合 T1 弛豫时间降低率低于 44.9%和 ADC 值低于 1553.5 s/mm 的标准，具有 91.8%的高特异性和 80.9%的准确性。
结论
提出的结合钆塞酸增强 MRI 上 T1 弛豫时间降低率低于 44.9%和 ADC 值低于 1553.5 s/mm 的标准有望评估 HCC 的 MVI 状态。
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