Radiology:钆塞酸增强MRI与扩散加权MR成像特点在识别细胞角蛋白19阳性肝细胞肝癌的价值

2018-01-30 shaosai MedSci原创

本研究旨在前瞻性验证磁共振成像(MRI)表现在预测角蛋白19(CK19)阳性肝细胞肝癌(HCC)的价值,评价单发CK19阳性患者较阴性患者切除性治疗的预后差异,并将结果发表在Radiology上。

本研究旨在前瞻性验证磁共振成像(MRI)表现在预测角蛋白19(CK19)阳性肝细胞肝癌(HCC)的价值,评价单发CK19阳性患者较阴性患者切除性治疗的预后差异,并将结果发表在Radiology上。

本研究共纳入了204例CK19阴性HCC和38例CK19阳性HCC并在治愈性切除前行钆塞酸增强MR扫描的患者。又两名放射科医生术前评价MR影像学表现。利用单变量和多变量分析评价鉴别两组的显着性表现。利用ROC分析,选取最佳鉴别截断值。两组术后无复发生存率进行比较。

在多变量分析中,肿瘤边界不规则、动脉期环状强化、肝胆期肿瘤-肝脏信号强度比减低和肿瘤-肝脏表观系数(ADC)比减低是预测CK19阳性HCC的独立预测因子;当结合上述3/4的征象,有63.2%(24/38; 95%CI: 46.0%, 78.2%)的CK19阳性HCC能够诊断,特异性为90.7% (185/204; 95%CI: 46.0%, 78.2%)。当所有上述征象均满足是,特异性为99.5% (203/204; 95%CI: 97.3%, 100%)。在CK19阳性HCC患者组无复发生存率要明显低于CK19阴性组1年后63.9% vs 90.0%, 2年后63.9% vs 79.9%, 3年后54.8% vs 70.2% , P = .001)。

本研究表明,通过钆塞酸增强和扩散加权MR成像,肿瘤边界不规则,动脉期环状强化、肿瘤-肝脏ADC比值减低和在HBP肿瘤-肝脏SI比减低有助于预测CK19阳性HCC及其在术后两年复发。

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    2018-12-15 xjy02
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