A Comparative Study Of³¹P-MRS And Dynamic Contrast-enhanced Mri In The Hepatocellular Carcinoma

ObjectiveTo collect the conventional MRI plain scan plus dynamically intensified image data,the31P-MRS data, and the spectrogram materials of the patients with primary carcinoma ofliver proved by operation; to compare the sensitivity, specificity, total coincidence rate,positive predictive value, negative predictive value, and Kappa value of the two indiagnosing hepatocellular carcinoma so as to realize the non-invasive diagnosis anddifferential diagnosis on the living bodies suffering hepatocellular carcinoma; and to getthem applied to the daily clinical work so as to diagnose hepatocellular carcinoma earlierand more accurately.Methods30cases were randomly chosen from the patients suffer hepatocellular carcinoma whoprepared to have clinical biopsy or operation, among which there were20male patientsand10female ones. They aged between30and75, with the average age as55years old.We conducted conventional plain scan plus dynamically intensified scan as well as31P-MRS scan, and then verified the pathology of all these studying targets through biopsyor operation. Post treatments were conducted respectively on the MRI plain scan plusdynamically intensified image data, the31P-MRS data, and the spectrogram materials ofthe patients suffering hepatocellular carcinoma. We also contrasted the results diagnosedby the MRI plain scan plus dynamically intensified images, the31P-MRS data, and thespectrogram materials with those of biopsy or pathological operation to compare the Kappavalues, sensitivity, specificity, total coincidence rates, positive predictive values, negativepredictive values of the diagnoses made by the two on patients suffering hepatocellularcarcinoma, and to establish a comparison table by combining the Kappa values, sensitivity,specificity, total coincidence rates, positive predictive values, and negative predictivevalues of the diagnoses. Results(1) Successful conventional MRI plain scan plus dynamically intensified scan as wellas31P-MRS scan were achieved on all patients.(2)25patients out of the30onesconducted pathological diagnoses were confirmed as having suffered hepatocellularcarcinoma, while among the remaining patients one was diagnosed as having liverdiffusive large B cell lymphoma, one was with liver cirrhosis nodules and three patientswere healthy.(3) The pathological diagnoses made after resectional operations were takenas the golden standards for diagnoses, and then they were compared with the results of theMRI plain scan plus dynamically intensified scan as well as the31P-MRS scan, resulting inthat the sensitivity of the MRI plain scan plus dynamically intensified scan in determiningthe property of diseases is84.0%and the specificity is80.0%, total coincidence rate is83.3%, positive predictive value is95.5%, negative predictive value is50.0%and kappavalue is0.516.The sensitivity of the31P-MRS scan in determining the property of diseasesis92.0%and the specificity is80.0%, total coincidence rate is90.0%, positive predictivevalue is95.8%, negative predictive value is66.7%and kappa value is0.677.The sensitivityof the MRI plain scan plus MRI dynamical intensification scan and combing31P-MRS indetermining the property of diseases is100%and the specificity is60.0%, totalcoincidence rate is93.3%, positive predictive value is92.6%, negative predictive value is100%and kappa value is0.714.Conclusion(1) The MRI plain scan plus dynamical intensified scan combining31P-MRS scan fordiagnosing hepatocellular carcinoma is of very high sensitivity, specificity, totalcoincidence rate, positive prediction value, and negative prediction value.(2)Goodconsistency exists in the MRI plain scan plus dynamical intensified scan combining31P-MRS scan for the diagnosis as well as the pathological diagnosis of hepatocellularcarcinoma, so they could be applied to conventional clinical implementation and substituteparts of aspiration biopsy.