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MR功能成像对肝细胞癌微血管侵犯的评估价值

王莉莉 李俊峰 窦郁 郭顺林 雷军强

引用本文:
Citation:

MR功能成像对肝细胞癌微血管侵犯的评估价值

DOI: 10.3969/j.issn.1001-5256.2018.12.038
基金项目: 

国家自然科学基金青年基金项目(81800528); 2018年甘肃省卫生行业科研计划项目(GSWSKY2018-24); 2018年兰州市城关区科技发展计划项目(2018SHFZ0023); 

详细信息
  • 中图分类号: R735.7;R445.2

Value of magnetic resonance functional imaging in evaluating microvascular invasion of hepatocellular carcinoma

Research funding: 

 

  • 摘要: 微血管侵犯作为预测肝细胞癌术后复发的指标目前只能通过"金标准"病理组织学确诊,常规影像学检查方法和血清学指标的检测在微血管侵犯研究中敏感度及特异度均较低,如果术前能够对其作出预测和评估,对于临床治疗方式的选择及患者预后的评估具有重要价值。近年来MR功能成像技术及新型对比剂发展较快,在肝细胞癌早期诊断和术后疗效随访及复发评估方面是研究的热点。简述了利用磁共振扩散加权成像的定量表观扩散系数对肝细胞癌微血管评估的意义,以及体素内不相干运动MR成像、扩散峰度成像新型扩散模型对其评估的潜在价值,同时分析了动态增强磁共振成像及钆塞酸二钠特异性增强MR对肝细胞癌是否存在微血管侵犯及预测其术后复发的应用现状。分析表明MR功能成像技术的发展及部分新技术的应用对肝细胞癌微血管侵犯的评估具有重要价值,可以进一步评估其术后复发及转移的风险,为临床早期诊断、合理采用手术及治疗方式提供可靠的定量评价指标。

     

  • [1] SAPISOCHIN G, CASTELLS L, DOPAZO C, et al. Single HCC in cirrhotic patients:Liver resection or liver transplantation? Long-term outcome according to an intention-to-treat basis[J]. Ann Surg Oncol, 2013, 20 (4) :1194-1202.
    [2] WU HL, ZHENG SJ, DUAN ZP. Route of metastasis of primary hepatic carcinoma from the perspective of anatomy[J]. J Clin Hepatol, 2017, 33 (10) :2009-2015. (in Chinese) 伍慧丽, 郑素军, 段钟平.从解剖学角度探讨原发性肝癌的转移途径[J].临床肝胆病杂志. 2017, 33 (10) :2009-2015.
    [3] CHOI JY, LEE JM, SIRLIN CB. CT and MR imaging diagnosis and staging of hepatocellular carcinoma:part I. Development, growth, and spread:Key pathologic and imaging aspects[J]. Radiology, 2014, 272 (3) :635-654.
    [4] RODRIGUEZ-PERALVAREZ M, LUONG TV, ANDREANA L, et al. A systematic review of microvascular invasion in hepatocellular carcinoma:Diagnostic and prognostic variability[J]. Ann Surg Oncol, 2013, 20 (1) :325-339.
    [5] QI YP, ZHONG JH, LIANG ZY, et al. Adjuvant transarterial chemoembolization for patients with hepatocellular carcinoma involving microvascular invasion[J]. Am J Surg, 2018.[Epub ahead of print]
    [6] YE JZ, CHEN JZ, LI ZH, et al. Efficacy of postoperative adjuvant transcatheter arterial chemoembolization in hepatocellular carcinoma patients with microvascular invasion[J]. World J Gastroenterol, 2017, 23 (41) :7415-7424.
    [7] ADLER M, LAROCCA L, TROVATO FM, et al. Evaluating the risk of hepatocellular carcinoma in patients with prominently elevated liver stiffness measurements by Fibro Scan:A multicentre study[J]. HPB (Oxford) , 2016, 18 (8) :678-683.
    [8] LI JW, LING WW, LU Q, et al. Liver stiffness and serum alphafetoprotein in discriminating small hepatocellular carcinoma from cirrhotic nodule[J]. Ultrasound Q, 2016, 32 (4) :319-326.
    [9] BAILLY M, VENEL Y, ORAIN I, et al. 18F-FDG PET in liver transplantation setting of hepatocellular carcinoma:Predicting histology?[J]. Clin Nucl Med, 2016, 41 (3) :e126-e129.
    [10] YANG C, WANG H, SHENG R, et al. Microvascular invasion in hepatocellular carcinoma:Is it predictable with a new, preoperative application of diffusion-weighted imaging?[J]. Clin Imaging, 2017, 41:101-105.
    [11] UNAL E, IDILMAN IS, AKATA D, et al. Microvascular invasion in hepatocellular carcinoma[J]. Diagn Interv Radiol, 2016, 22 (2) :125-132.
    [12] SUH YJ, KIM MJ, CHOI JY, et al. Preoperative prediction of the microvascular invasion of hepatocellular carcinoma with diffusionweighted imaging[J]. Liver Transpl, 2012, 18 (10) :1171-1178.
    [13] XU P, ZENG M, LIU K, et al. Microvascular invasion in small hepatocellular carcinoma:Is it predictable with preoperative diffusion-weighted imaging?[J]. J Gastroenterol Hepatol, 2014, 29 (2) :330-336.
    [14] ZHAO J, LI X, ZHANG K, et al. Prediction of microvascular invasion of hepatocellular carcinoma with preoperative diffusion-weighted imaging:A comparison of mean and minimum apparent diffusion coefficient values[J]. Medicine (Baltimore) , 2017, 96 (33) :e7754.
    [15] LEE S, KIM SH, HWANG JA, et al. Pre-operative ADC predicts early recurrence of HCC after curative resection[J]. Eur Radiol, 2018.[Epub ahead of print]
    [16] LI H, ZHANG J, ZHENG Z, et al. Preoperative histogram analysis of intravoxel incoherent motion (IVIM) for predicting microvascular invasion in patients with single hepatocellular carcinoma[J]. Eur J Radiol, 2018, 105:65-71.
    [17] WOO S, LEE JM, YOON JH, et al. Intravoxel incoherent motion diffusion-weighted MR imaging of hepatocellular carcinoma:Correlation with enhancement degree and histologic grade[J]. Radiology, 2014, 270 (3) :758-767.
    [18] ZHAO W, LIU W, LIU H, et al. Preoperative prediction of microvascular invasion of hepatocellular carcinoma with IVIM diffusionweighted MR imaging and Gd-EOB-DTPA-enhanced MR imaging[J]. PLo S One, 2018, 13 (5) :e0197488.
    [19] ROSENKRANTZ AB, SIGMUND EE, WINNICK A, et al. Assessment of hepatocellular carcinoma using apparent diffusion coefficient and diffusion kurtosis indices:Preliminary experience in fresh liver explants[J]. Magn Reson Imaging, 2012, 30 (10) :1534-1540.
    [20] WANG WT, YANG L, YANG ZX, et al. Assessment of microvascular invasion of hepatocellular carcinoma with diffusion kurtosis imaging[J].Radiology, 2018, 286 (2) :571-580.
    [21] WU TH, HATANO E, YAMANAKA K, et al. A non-smooth tumor margin on preoperative imaging predicts microvascular invasion of hepatocellular carcinoma[J]. Surg Today, 2016, 46 (11) :1275-1281.
    [22] SHIRABE K, KAJIYAMA K, ABE T, et al. Predictors of microscopic portal vein invasion by hepatocellular carcinoma:Measurement of portal perfusion defect area ratio[J]. J Gastroenterol Hepatol, 2009, 24 (8) :1431-1436.
    [23] AHN SY, LEE JM, JOO I, et al. Prediction of microvascular invasion of hepatocellular carcinoma using gadoxetic acid-enhanced MR and (18) F-FDG PET/CT[J]. Abdom Imaging, 2015, 40 (4) :843-851.
    [24] SUN Y, ZHANG N, HOU J, et al. Value of Gd-EOB-DTPAenhanced MRI in diagnosis of hepatocellular carcinoma[J]. J Clin Hepatol, 2018, 34 (1) :129-132. (in Chinese) 孙玉, 张楠, 侯洁, 等.钆塞酸二钠MRI对肝细胞癌的诊断价值[J].临床肝胆病杂志, 2018, 34 (1) :129-132.
    [25] KIM KA, KIM MJ, JEON HM, et al. Prediction of microvascular invasion of hepatocellular carcinoma:usefulness of peritumoral hypointensity seen on gadoxetate disodium-enhanced hepatobiliary phase images[J]. J Magn Reson Imaging, 2012, 35 (3) :629-634.
    [26] NISHIE A, ASAYAMA Y, ISHIGAMI K, et al. Clinicopathological significance of the peritumoral decreased uptake area of gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid in hepatocellular carcinoma[J]. J Gastroenterol Hepatol, 2014, 29 (3) :561-567.
    [27] SHIN SK, KIM YS, SHIM YS, et al. Peritumoral decreased uptake area of gadoxetic acid enhanced magnetic resonance imaging and tumor recurrence after surgical resection in hepatocellular carcinoma:A STROBE-compliant article[J]. Medicine (Baltimore) , 2017, 96 (33) :e7761.
    [28] MIN JH, KIM YK, LIM S, et al. Prediction of microvascular invasion of hepatocellular carcinomas with gadoxetic acid-enhanced MR imaging:Impact of intra-tumoral fat detected on chemicalshift images[J]. Eur J Radiol, 2015, 84 (6) :1036-1043.
    [29] KIM MJ, LEE M, CHOI JY, et al. Imaging features of small hepatocellular carcinomas with microvascular invasion on gadoxetic acid-enhanced MR imaging[J]. Eur J Radiol, 2012, 81 (10) :2507-2512.
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