| PART I Study on correlation of DCE-MRI quantitative parameters in tumor angiogenesis for hepatocellular carcinomaObjective:To investigate the value of dynamic contrast enhancedMRI(DCE-MRI)in diagnosis of primary liver cancer(PLC)and the correlation between perfusion parameters and pathological results,including the pathological grade,microvascular density(MVD)and vascular endothelial growth factor(VEGF)by contrastive analyzing the results of pathology and the results of DCE-MRI.Methods:From December,2016 to January,2017,one hundred and twenty-six patients withliver lumps were examined by DCE-MRI and were verified by pathological findings.There were one hundred and ten men and sixteen womem in those patients.Their age were from twenty-eight to seventy-six and average age was 49.590±10.326years old.After the exam,images were sent to the post-processing workstation of GE FunctionTooL 4.4 and measured by Tofts model,two-compartment model of O.K software.When drawing the outline of region of interest,the vascular area and necrosis area should be avoided.The perfusion parameters including the transfer constant(Ktrans),the volume of extravascular extracellular space per unit volume of tissue(Ve)and the rate constant(Kep)were calculated three times.The average values of parameters among the three times were the lesion parameters.Three normal liver tissues of the same level were selected as reference groups,which average values of parameters were the reference parameters.The relative parameters were the ratio of lesion parameters/reference parameters.The parameters of precancerous lesions and parameters of the PLC were tested for differences.The parameters were contrastive analyzed respectively with pathological grade,MVD and VEGF.Statistic analyses were completed by using SPSS 21.0.Results:There were 24 cases of precancerous lesions and 102 cases of PLC in the 126 patients.Among the 102 cases of PLC,20 ones were high differentiated,68 ones were middle differentiated and 14 ones were low differentiated.44 ones' VEGF expressed negative(-),50 ones' VEGF expressed low level(+),8 ones' VEGF expressed middle level(++)and no one expressed high level(+++).The patients' MVD marked by CD34 were in the range of 10 and 100.In the two groups,the difference of lesion Ktrans and relative Ktrans had statistical significance.The value of t were 3.692,3.732respectively.The value of P were 0.000,0.000 respectively.When lesion Ktrans was 0.291(min-1),the sensitivity of the diagnosis of PLC was 0.916 and the specificity was 0.760.When relative Ktrans was 2.053,the sensitivity of the diagnosis of PLC was 0.739 and the specificity was 1.000.In the two groups,the difference of lesion Ve and relative Ve had statistical significance.The value of t were 3.726,5.598 respectively.The value of P were 0.001,0.000 respectively.When lesion Ve was 0.425,the sensitivity of the diagnosis of PLC was 0.399 and the specificity was].000.When relative Ve was 4.272,the sensitivity of the diagnosis of PLC was 0.879 and the specificity was 0.913.In the two groups,the difference of lesion Kep and relative Kep had no statistical significance.The value of t were 1.413,-1.328 respectively.The value of P were 0.157,0.169 respectively.The lesion Ktrans,lesion Kep,lesion Ve and relative Ktrans,relative Kep,relative Ve had no correlation with the pathological grade.The value of r were 0.153,0.075,0.113,0.125,0.218,-0.129 respectively and the value of P were 0.271,0.569,0.403,0.369,0.113,0.346 respectively.The values of lesion Ktrans,lesion Kep,relative Ktrans and relative Kep of middle differentiated PLC were biggest.The lesion Ktrans had a positive correlation with MVD,r=0.519,P=0.000.The lesion Kep had no correlation with MVD,r=0.216,P=0.121.The lesion Ve had no correlation with MVD,has no correlation with MVD,r=0.152,P=0.297.The relative Ktrans had a positive correlation with MVD,r=0.789,P=0.000.The relative Kep had a positive correlation with MVD,r=0.721,P=0.000.The relative Ve had no correlation with MVD,r=-0.163,P=0.271.The lesion Ktrans,lesion Kep and lesion Ve had no correlation with VEGF.The value of r were 0.021,0.018,0.076 respectively.The value of P were 0.885,0.931,0.655 respectively.The relative Ktrans and the relative Kep had positive correlation with VEGF.The value of r were 0.401,0.383 respectively.The value of P were 0.003,0.006 respectively.Conclusions:DCE-MRI could reflect the microcirculation function ofPLC.The perfusion parameters of DCE-MRI have great reference value not only in identifying the precancerous lesion and PLC but also in evaluating pathological characteristics.PART ? Study on value of DCE-MRI quantitative parameters in differential diagnosis forhepatic occupying lesionObjective:To study the values of quantitative parameters of MRI indiagnosis of benign and malignant liver tumors and explore its diagnostic efficacy.Methods:Consecutive75patients with benign or malignant liver tumors underwent plain scanning and dynamic contrast-enhanced MR scanning.Totally 84 lesions were confirmed by pathology or follow-up.The DCE-MRI quantitative parameters(Ktrans,Kep,Ve and iAUC)of the lesions and the surrounding normal liver O.K software were acquired.The independent sample T test was used to compare the quantitative parameters.The optimal parameters values of benign and malignant liver tumors were determined by plotting TIC curves.Results:The mean of quantitative parameters of HCC and benign lesions were larger than the surrounding normal liver tissue.Ktrans,Kep,Ve and iAUC between HCC and surrounding normal liver tissue had significant difference(p<0.05),Ktrans and iAUC between benign lesions and surrounding normal liver tissue had significant difference(p<0.05).Ktrans,Kep and iAUC between HCC and benign lesions had significant difference(p<0.05).The diagnostic effectiveness of Ktrans = 0.216min-1,with 81.7%sensitivity and 66.8%specificity,was greater than Kep=0.478 and iAUC=24.709.Conclusion:The DCE-MRI quantitative analysis can provide a reference for the differential diagnosis of HCC from benign liver tumors. |
PDF Full Text Request