The Value Of MRI Histogram Parameters Based On Whole Tumor Volume In Differentiation Of The Solid Space Occupying Lesions Of Liver

Objective: To explore the clinical value of whole-tumor plain scan and enhanced MRI histogram parameter differential diagnosis of the solid space occupying lesions of liver.Materials and Methods: From October 2015 to January 2019,126 patients with the solid space occupying lesions of liver were included in our hospital,with 126 lesions.After the flat scan and enhanced images of the patient were exported from the computer center,then imported into the FireVoxel software for layer-by-layer delineation of the focus area of interest,.Then each lesions of the histogram data is converted to frequency distribution table and import the SPSS22.0 analysis,final record histogram parameters,including the minimum value,mean,median,maximum value,standard deviation,inhomogeneity,skewness,kurtosis,entropy,P10,P25,P75,P90,with independent sample t-test or the Mann-Whitney U test compared to the parameters.The area under the ROC curve was used to evaluate the diagnostic efficacy of histogram parameters in differentiating benign and malignant liver solid space occupying lesions,HCC from cirrhotic nodules,HCC and ICC,respectively.Results: 1.A total of 126 lesions including 73 malignant lesions(52 cases of HCC,10 cases of ICC,3 cases of combined hepatocellular-cholangiocarcinoma,and 8 cases of liver metastases)and 53 benign lesions(hepatic hemangioma in 32,RN in 13,DN in 4,HCA in 1,inflammatory myofibroblastic tumor in 1,FNH in 1,hepatic tuberculosis in 1).2.Histogram parameters of benign and malignant liver solid space occupying lesions The inhomogeneity and entropy of the malignant group were higher than that of the benign group,and the standard deviation of the benign group was higher than that of the malignant group in T1 WI.Mean,median,inhomogeneity,P10 and P25 of the malignant group were higher than those of the benign group in arterial phase.The inhomogeneity,entropy and kurtosis of the malignant group were higher than that of the benign group in portal phase.The standard deviation,P75 and P90 of benign group were higher than that of the malignant group in delayed phase.The median and P75 in the benign group were higher than that in the malignant group,and the skewness in the benign group was lower than that in the malignant group in hepatobiliary phase.The differences(P<0.05)were statistically significant.The diagnostic efficacy of specificity skewness was the highest(AUC=0.721).When the cut-off value was 0.21,the sensitivity and specificity of malignant lesions were 65.8% and 77.9%,respectively.3.Histogram parameters of HCC and cirrhosis nodules The entropy and kurtosis of the cirrhotic nodule group on T1 WI were lower than that of HCC.The minimum value of HCC on T2 WI was lower than that of cirrhotic nodules,and the maximum value of HCC was higher than that of cirrhotic nodules.The maximum value of HCC was higher than that of cirrhotic nodules in arterial phase.The maximum value,mean value,entropy,P10 and P25 of HCC in portal phase were higher than that in cirrhotic nodules.P75 of HCC was lower than that of cirrhotic nodules,and the skewness of HCC was greater than that of cirrhotic nodules in hepatobiliary phase.The differences(P<0.05)were statistically significant.The diagnostic value of specificity skewness was the highest(AUC=0.752),and the cut-off value was 0.24,the diagnostic sensitivity and specificity of HCC were 69.2% and 83.3%,respectively.4.Histogram parameters of HCC and ICC The minimum ICC value of T1 WI was lower than that of HCC,and the standard deviation and inhomogeneity of ICC were higher than that of HCC.The maximum,mean,median,P10,P25,P75 and P90 of the ICC group in T2 WI were higher than that in HCC group.The minimum value of the arterial phase ICC is less than that of HCC.The inhomogeneity of ICC in portal phase was higher than that of HCC.The differences(P <0.05)were statistically significant.P25 had the highest diagnostic efficiency(AUC=0.785)in T2 WI,with a cut-off value of 153.50,the sensitivity and specificity of HCC were 57.7% and 94.4%,respectively.Conclusion: 1.The hepatobiliary phase skewness,P10?P25 of arterial phase were of high value in differentiating the benign and malignant liver solid space occupying lesions,among which the skewness had the highest diagnostic efficiency.2.Skewness in the hepatobiliary phase,the maximum value in the portal phase,and the entropy of T1 WI are of high value in differentiating HCC from cirrhotic nodules,among which the skewness has the highest diagnostic efficiency.3.In the differentiation between HCC and ICC,the P25,median and P10 of T2 WI have high diagnostic value,among which P25 has the highest diagnostic efficiency.