Comparison Of T2WI And DWI In The Application Of LI-RADS With Cirrhosis Caused By Hepatitis B

The purpose of the working group（the liver imaging reporting and data system LI-RADS）is to standardize the interpretation,report and data collection of the high-risk patients in hepatocellular carcinoma（HCC）.According to the main signs and auxiliary signs defined by LI-RADS,the possibility of the liver"abnormal discovery"is arranged as the possibility of HCC.The 5 main signs of LI-RADS includes arterial phase hyper-enhancement、diameter and washout performance,threshold growth and capsule performance.The 20 ancillary signs that may favor benignity and malignancy,the malignancy includes HCC and other malignant tumor.The American Academy of Radiology（ACR）developed and promoted the sistem.The Committee of experts not only includes radiologists,but also includes pathologists,hepatologists,surgeons,lexis experts and some employees of ACR.Baseing on the literature review,rounds of testing and iteration,expert opinion,feedback from users the LI-RADS is developmented,and as far as possible to consistent with the United States Institute of liver diseases（AASLD）、the organ procurement and Transplantation Network-United Network for Organ Sharing（OPTN-UNOS）related contents.Mild-moderate T2 hyper-intensity means that on the T2WI,the signal intensity of"abnormal discovery"is higher than the liver and less than that of bile ducts or other simple-fluid.It is an auxiliary sign of HCC and does not have the characteristic of HCC.This sign can be used to upgrade the category highest to LR-4,so HCC can not be confirmed according to this sign.With Cirrhosis Caused by hepatitis B,Our research aims to analysis the imaging features and properties of nodules,and to explore the application value of two auxiliary signs（Mild-moderate T2hyper-intensity,Restricted diffusion）defined by LI-RADS.It is better to understand the LI-RADS（2014 Edition）and played to category the nodules with cirrhosis Caused by hepatitis B.Objective:To compared the value of T2WI mild-moderate signal and restricted diffusion to diagnosis the hepatocellular carcinoma（HCC）with cirrhosis caused by hepatitis B virus in the liver imaging reporting and data system,（LI-RADS 2014 edition）.Methods:A total of 69 HCC patients with 77 lesions（LI-RADS 3-5,size of11mm×7mm-127 mm×91 mm）in Beijing Friendship Hospital from January 2012 to November 2016 were retrospectively analyzed.All of these patients have MRI and multiphase dynamic enhanced images.These images were analyzed by two radiologists which have worked more than five years.If a disagreement occurred,LAVA+DCE were combined to reach a consensus.The apparent diffusion coefficient（ADC）and contrast noise ratio（CNR）of DWI and T2WI sequences were compared,and whether the recognition of the two signs is consistent.Results:1.There is no significant statistical significance between T2WI mild-moderate signal and restricted diffusion in the recognition of lesions（LI-RADS 3-5）（P>0.05）,while the sensitivity with DWI b=600s/mm2（70.1%）was significantly higher than DWI b=0 s/mm2（61.0%）（P<0.05）.2.All of the CNR on DWI sequences（b=0,600 s/mm²）were larger than that of on T2WI（P<0.01）.There is no statistical significance of CNR between the DWI（b=0s/mm²）and DWI（b=600s/mm²）.There is no statistical significance of the CNR with many lesions on the same sequence.The CNR of the lesion is correlated with the imaging sequence.3.The relevant of ADC between diameter and fibrosis of lesions.There is no statistical significance of ADC between the lesion and the liver with Cirrhosis Caused by hepatitis B in the same crosssectional image[1.42±0.49)×10^-33 mm²/s、（1.50±0.48）×10^-3mm²/s,P>0.05].The ADCs of lesions with diameter<20 mm is larger than that of lesions with diameter≥20 mm[（1.57±0.37）×10^-3 mm²/s、（1.37±0.51）×10^-3 mm²/s,P<0.05].It means that the ADC is positively correlated with the size of the lesion.Conclusion:There was no significant statistical significance of sensitivity between restricted diffusion and T2WI mild-moderate signal.The sensitivity of DWI（b=600 s/mm²）is higher than that of DWI（b=0s/mm²）.The change of signals on DWI do not only reflect the physiological informations of disease,but also reflect the T2 of the lesion.The sensitivity to the lesions is no significant statistical significance between DWI and T2WI.The hyper-intensity on DWI may be caused by intrinsic T2 signal hyper-intensity rather than restricted diffusion.Hyper-intensity on DWI is not as hyper-intensity on T2-weighted as a separate ancillary criterion in LI-RADS.