表观弥散系数平均值及最小值与肝癌病理学特征的相关性研究

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摘要目的：探讨表观弥散系数平均值（ADCmean）、最小值（ADCmin）在鉴别肝癌病理分化程度的价值。方法：回顾性分析46例经病理证实的肝癌患者，包括肝细胞癌（36例）、胆管细胞癌（10例），并将其分为高、中、低分化组（分别为10、24、12例）。所有患者均行MRI平扫、增强及DWI序列扫描，综合各扫描序列，测量病灶实质部分的ADCmean值、ADCmin值，对比ADC值在高、中、低分化肝癌中的差异。采用受试者工作特征曲线（ROC）分析ADCmin值在鉴别低分化与中高分化肝癌的临界值及其敏感度、特异度。结果：低分化组ADCmean值及ADCmin值均低于中分化和高分化组，且差异具有统计学意义（P＜0.05）；在低分化与中高分化肝癌的鉴别中，ADCmin值具有较高的诊断效能，ROC曲线下面积（AUC）为0.842，其敏感度、特异度分别为86.2%、71.4%。结论：ADCmin值在预测肝癌的病理分化程度中的作用要优于ADCmean值。

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	王亚婷
	朱艳
	陆洋
	刘艳
	柏根基

关键词 ：肝肿瘤, 病理学, 磁共振成像

Abstract：Objective: To investigate the value of ADCmin and ADCmean in determination of liver cancer pathological degree of differentiation. Methods: Forty-six patients with pathologically confirmed liver cancer were analyzed retrospectively, including 36 cases of hepatocellular carcinoma and 10 cases of cholangiocarcinoma(10 well, 24 moderately and 12 poorly differentiated). All patients underwent conventional MRI and DWI examinations. The ADCmin and ADCmean values of well, moderately and poorly differentiated liver cancer were measured and compared. ROC curves are used to evaluate the critical value of ADCmin between poorly differentiated and moderately to well differentiated liver cancer. The sensitivity and specificity of ADCmin are also assessed. Results: The values of ADCmin and ADCmean were lower in poorly differentiated liver cancer than moderately to well differentiated liver cancer, with significantly statistical differences(P<0.05). The sensitivity and specificity of ADCmin for distinguishing poorly differentiated from moderately to well differentiated liver cancer were 86.2% and 71.4% respectively. The calculated area under the curve(AUC) was 0.842. Conclusions: ADCmin is better than ADCmean in discriminating poorly differentiated from moderately to well differentiated liver cancer.

Key words： Liver neoplasms Pathology Magnetic resonance imaging

收稿日期: 2016-11-10

PACS:	Ｒ735.7
	Ｒ445.2

通讯作者: 柏根基，南京医科大学附属淮安第一医院影像科，223300。E-mail：hybgj0451@163.com

作者简介: 王亚婷（1990-），女，江苏人，在读硕士研究生。E-mail：593793621@qq.com

引用本文:

王亚婷，朱艳，陆洋，刘艳，柏根基. 表观弥散系数平均值及最小值与肝癌病理学特征的相关性研究[J]. 中国临床医学影像杂志, 2017, 28(11): 805-809.
WANG Ya-ting, ZHU Yan, LU Yang, LIU Yan, BAI Gen-ji. The relationship between values of ADCmin and ADCmean and pathological features of liver cancer: a primary study. JOURNAL OF CHINA MEDICAL IMAGING, 2017, 28(11): 805-809.

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http://www.jccmi.com.cn/CN/ 或 http://www.jccmi.com.cn/CN/Y2017/V28/I11/805

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