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目的分析肝细胞癌(hepatocellular carcinoma,HCC)的氢质子磁共振波谱(1H-MRS)及扩散加权成像(DWI)表现,评价HCC代谢物变化与表观扩散系数(ADC)值的相关性。资料与方法对经手术病理证实的29例30个HCC病灶分别进行DWI及单体素波谱分析,测量HCC胆碱峰(Cho)、脂质峰(Lip)的相对浓度及HCC的ADC值,对Cho/(Cho+Lip)比值与ADC值进行线性相关分析。结果30个HCC的Cho/(Cho+Lip)比值及ADC值分别为(0.25±0.21)和(1.49±0.27)mm2/s,HCC的Cho/(Cho+Lip)比值与ADC值呈负相关(P<0.05)。质地均一、无明显出血坏死HCC(n=10)的Cho/(Cho+Lip)比值明显升高,ADC值明显下降;不均质局灶出血坏死HCC(n=13)的Cho/(Cho+Lip)比值轻度下降,ADC值轻度升高;明显脂肪变性(n=2)及透明细胞型(n=2)HCC的Cho/(Cho+Lip)比值很低,但是ADC值无明显升高;纤维基质丰富、无明显坏死、质地均一HCC(n=3)的Cho/(Cho+Lip)比值及ADC值均较低。结论1H-MRS与ADC值结合能基本反映HCC的肿瘤组织成分变化,有助于HCC的诊断、鉴别诊断和活体肿瘤成分分析。
Objective To analyze the 1H proton magnetic resonance spectroscopy (1H-MRS) and diffusion-weighted imaging (DWI) of hepatocellular carcinoma (HCC) and evaluate the correlation between HCC metabolites and apparent diffusion coefficient (ADC) Materials and Methods The 29 HCC lesions of 30 HCC confirmed by surgery and pathology were analyzed by DWI and single elemental spectroscopy respectively. The relative concentrations of Hc choline peak (Cho), lipids (Lip) and ADC value of HCC were measured. Cho / (Cho + Lip) ratio and ADC values for linear correlation analysis. Results The Cho / Cho ratio and ADC value of 30 HCCs were (0.25 ± 0.21) and (1.49 ± 0.27) mm2 / s, respectively. The Cho / (Cho + P <0.05). The Cho / (Cho +) ratio of HCC (n = 10) without hemorrhage and necrosis was significantly increased, and the ADC value was significantly decreased. Cho / (Cho + The ratio of Cho / (Cho + Lip) in HCC was lower than that in clear cell (n = 2) and clear cell type (n = 2) High, fibrous matrix was rich, no obvious necrosis, Cho / (Cho + Lip) ratio and ADC value were lower in HCC with uniform texture (n = 3). Conclusion The combination of 1H-MRS and ADC value can basically reflect the change of tumor tissue components of HCC, which is helpful for the diagnosis, differential diagnosis and in vivo tumor component analysis of HCC.