Evaluation Of The Effect Of Microwave Ablation On Hepatocellular Carcinoma By Diffusion Kurtosis Imaging

Objective:To compare the changes of diffusion kurtosis imaging(DKI)and diffusion-weighted imaging(DWI)related parameters of hepatocellular carcinoma(HCC)after microwave ablation(MWA),and to explore the predictive value of DKI and DWI for the efficacy of HCC after microwave ablation.Methods:From November 2019 to December 2020,44 patients with HCC were selected,including 52 lesions.All patients underwent microwave ablation under the guidance of contrast-enhanced ultrasound.According to the recurrence within six months,the patients were divided into non recurrence group and recurrence group.All patients underwent MRI plain scan,enhanced MRI,DWI and DKI examination before ablation and one month,three months and six months after ablation.Apparent diffusion coefficient(ADC),DKI related parameters,mean diffusion kurtosis(MK)and mean diffusion coefficient(MD)were measured.The independent sample t-test was used to compare the differences of parameters between recurrence group and non recurrence group.The paired t-test was used to compare the intra-group parameters differences in the two groups.A p-value of<0.05 was considered significant.The receiver operating characteristic curve(ROC)was drawn before and six months after operation to calculate the diagnostic efficacy of relevant parameters.Results:1.52 cases were ablated,10 cases in recurrence group and 42 cases in non recurrence group.There were significant differences in ADC,MK and MD values between recurrence group and non recurrence group at one month,three months and six months after MWA(p<0.05).There was no significant difference in ADC,MK and MD values between preoperative and postoperative one month,three months and six months in recurrence group(p>0.05),while there was significant difference in ADC,MK and MD values between preoperative and postoperative one month,three months and six months in non recurrence group(p<0.05).2.The areas under the curve of ADC,MK and MD after MWA were 0.700,0.974 and 0.754,respectively,which were higher than those before MWA(0.581,0.671 and 0.592,respectively).Furthemore,the areas under the curve,sensitivity and specificity of MK after MWA were 0.974,90.00%and 97.62%,respectively,which were higher than those of ADC(0.700,80.00%and 71.43%,respectively)and MD(0.754,60.00%and 92.86%,respectively),indicating the diagnostic efficiency of MK maximum.Conclusion:After microwave ablation,DKI can effectively predict the efficacy of microwave ablation in patients with hepatocellular carcinoma,and MK value is the best.