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中国癌症防治杂志

中国癌症防治杂志 ›› 2018, Vol. 10 ›› Issue (4): 310-313.doi: 10.3969/j.issn.1674-5671.2018.04.13

• 临床研究 • 上一篇    下一篇

3.0T MR动脉自旋标记技术对早期原发性肝癌的诊断价值

  

  1. 广西贵港市人民医院放射科
  • 出版日期:2018-08-25 发布日期:2018-09-25

The value of  3.0T MR arterial spin labeling in the diagnosis of early-stage primary liver cancer

  • Online:2018-08-25 Published:2018-09-25

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摘要：

目的 探讨3.0T MR动脉自旋标记(arterial spin labeling,ASL)技术诊断早期原发性肝癌的价值。方法 对经肝脏穿刺活检病理证实的22例早期原发性肝癌患者(早期肝癌组)及20名健康志愿者(健康对照组)行3D-假连ASL(pseudo-CASL,pCASL)序列扫描,比较两组平均、最高及最低血流量(blood flow,BF),并采用受试者工作特征曲线(receiver operating characteristic curve,ROC)分析其诊断效能。结果 早期肝癌组肿瘤组织的平均、最高及最低BF值均较健康对照组肝组织增高[(108.69±27.32) mL/(100g·min) vs (78.85±34.89) mL/(100g·min),(138.59±61.61) mL/(100g·min) vs (99.32±50.01) mL/(100g·min),(70.18±12.01) mL/(100g·min) vs (48.63±11.77) mL/(100g·min),P<0.05]。平均、最高及最低BF值鉴别早期肝癌组肿瘤组织与健康对照组肝组织的ROC曲线下面积分别为0.736?0.686及0.900?以BF最低值53.64 mL/(100g·min)为阈值鉴别早期肝癌组肿瘤组织与健康对照组肝组织,敏感度、特异度、阳性预测值、阴性预测值和准确率分别为95.5%、70.0%、95.5%、70.0%和83.3%。结论 3.0T MR 3D-ASL技术能反映早期原发性肝癌与健康对照组肝脏血流灌注差异,有助于原发性肝癌早期诊断。

关键词:  肝肿瘤, 肝组织, 血流灌注, 磁共振成像, 动脉自旋标记, 诊断

Abstract:

 Objective To determine the value of 3.0T MR arterial spin labeling(ASL) in the diagnosis of early-stage primary liver cancer. Methods A total of 22 newly diagnosed early stage primary liver cancer patients proven by liver biopsy and 20 healthy volunteers were enrolled and underwent MR examination, including 3D pseudo-continuous ASL(pCASL) series. The mean, maximum and minimum blood flow(BF) of liver derived in pCASL of early stage primary liver cancer and healthy controls were measured and compared. Receiver operation characteristic(ROC) curve was used to analyze the diagnostic cutoff and efficiency. Results The mean, maximum and minimum BF in early stage primary liver cancer tissue were,respectively,(108.69±27.32) mL/(100g·min), (138.59±61.61) mL/(100g·min),and(70.18±12.01) mL/(100g·min) , which were significantly higher than in the healthy controls[(78.85±34.89) mL/(100g·min), (99.32±50.01) mL/(100g·min), and (48.63±11.77) mL/(100g·min)](P<0.05). The area under the ROC curve of mean, maximum and minimum BF value was 0.736, 0.686 and 0.900, respectively. Setting the minimum BF value 53.64 mL/(100g·min) as the cutoff threshold to differentiate early stage primary liver cancer tissue and healthy controls, the sensitivity, specificity, positive predictive value, negative predictive value and accuracy was 95.5%, 70.0%, 95.5%, 70.0% and 83.3%, respectively. Conclusions 3.0T MR 3D-ASL may reflect the difference of perfusion of liver derived between early stage primary liver cancer and healthy controls, which is significant for the early diagnosis of primary liver cancer.

Key words:  Liver neoplasms, Liver tissue, Blood perfusion, Magnetic resonance imaging, Arterial spin labeling, Diagnosis