摘要
目的:探索细胞外体积分数(extracellular volume fraction,fECV)评估肝细胞癌分化程度的价值。方法:选取经辽宁省肿瘤医院手术后病理学检查确诊为肝细胞癌并行肝脏多期动态增强CT扫描患者41例,通过平扫及平衡期(注射对比剂140 s后)图像计算肝脏肿瘤部分(Etumor)及主动脉(Eaorta)绝对强化值,并通过以下公式计算fECV值:fECV(%)=Etumor/Eaorta[100-Hct(%)]。根据肝细胞癌Edmondson-Steiner病理学分级分为高分化组(Ⅰ、Ⅱ级)和低分化组(Ⅲ、Ⅳ级),分析两组患者肿瘤部分的fECV值差异是否有统计学意义。结果:高分化组肿瘤部分fECV值为(30.61±7.84)%,低分化组为(21.13±6.17)%,高分化组和低分化组肿瘤部分的fECV值差异有统计学意义(P<0.01),fECV值评估肝细胞癌分化程度的曲线下面积(area under curve,AUC)为0.869(95%CI:0.759~0.979);高分化组与低分化组诊断界值为28.56%,灵敏度为71%,特异度为90%。结论:fECV可以作为肝脏多期动态增强CT检查中无创性评估肝细胞癌分化程度的指标。
Objective:To explore the value of extracellular volume fraction(fECV)in assessing the degree of differentiation of hepatocellular carcinoma(HCC).Methods:A total of 41 patients with HCC diagnosed by surgical pathology and routine liver multi-phase dynamic contrast-enhanced CT scan were enrolled in Liaoning Cancer Hospital&Institute.The absolute enhancement values of the liver tumor(Etumor)and the aorta(Eaorta)were calculated by the plain and equilibration period(after injection of the contrast agent for 140 s),and then we calculated the fECV values by the following formula:fECV(%)=Etumor/Eaorta[100-Hct(%)].According to the Edmondson-Steiner classification of HCC,the lower grade group(gradeⅠandⅡ)and the higher grade group(gradeⅢandⅣ)were compared.We explored whether the difference of fECV value between the two groups was statistically significant.Results:The fECV value of the tumor in lower grade group was(30.61±7.84)%,and that in the higher grade group was(21.13±6.17)%.The fECV values of the HCC in the lower grade group and the higher grade group were statistically significant(P<0.01),and the area under curve(AUC)of the fECV value for evaluating the differentiation of HCC was 0.869(95%CI:0.759~0.979);the diagnostic boundary value of the lower grade group and the higher grade group was 28.56%.The sensitivity was 71%and the specificity was 90%.Conclusion:Extracellular volume fraction can be used as an indicator for non-invasive assessment of HCC differentiation by liver multi-phase dynamic contrast-enhanced CT examination.
作者
崔凤娇
李琳
罗娅红
于庆
李娜
王丹丹
CUI Fengjiao;LI Lin;LUO Yahong;YU Qing;LI Na;WANG Dandan(Department of Radiology,Liaoning Cancer Hospital&Institute,Shenyang 110042,Liaoning Province,China;Graduate School,Dalian Medical University,Dalian 116044,Liaoning Province,China)
出处
《肿瘤影像学》
2020年第3期303-307,共5页
Oncoradiology
基金
2018年辽宁省中央引导地方科技发展专项(2018416029)。
关键词
肝细胞癌
CT
X线计算机
细胞外体积分数
Hepatocellular carcinoma
CT
X-ray computed
Extracellular volume fraction
