Study Of Hepatocellular Carcinoma With Diffusion Weighted Imaging And Analysis Of Hepatic Tumors Using In Vivo And In Vitro Proton Magnetic Resonance Spectroscopy

Purpose:To compare the diagnostic performance of DWI and dynamic Gd-DTPA-enhanced MRI for hepatocellular carcinoma(HCC);investigate the value of in vivo proton magnetic resonance spectroscopy(MRS)in the assessment of large focal hepatic tumors; investigate the metabolic changes of normal liver,benign hepatic tumor and HCC tissue by high-resolution magic angle spinning 1H nuclear magnetic resonance(HR-MAS 1H NMR) spectroscopy.Materials and Methods:81 patients underwent both DWI and dynamic Gd-DTPA-enhanced MRI studies of the liver for HCC detection and the MR data were retrospectively analyzed;MRS of 53 patients and 19 normal volunteer was carried out using a whole-body 1.5-T scanner;Liver tissue specimens from normal liver(n=9),benign(n=7)and HCC(n=9)were analysed by HR-MAS 1H NMR spectroscopy at 11.7 Tesla.Result:Sensitivity,of DWl was significantly higher than Gd-DTPA-enhanced MR images for detection of total HCCs,HCCs smaller than 15 mm,p<0.05;A significantly statistical difference (P<0.05)Was achieved in the mean choline-to-noise ratios between HCC and normal liver.The glycine,taurine,choline,glutamate,alanine and valine of HCC tissues were significant elevation compared to histologically normal or benign tissue.Conclusion:Sensitivity of DWI for detection of HCCs was significantly higher than Gd-DTPA-enhanced MR images;In vivo proton MRS is technically feasible for the evaluation of focal hepatic lesions and provides metabolic information for diagnosis;the metabolic character of HCC was great different from normal liver or benign hepatic tumor tissue.