Application Study On Dynamic Contrast-enhanced Value Of3.0T MRI And Muti-slice CT, Diffusion-weighted Imaging In The Diagnosis Of Hepatocellular Carcinoma

Part Ⅰ The Application Study on Dynamic Contrast-enhanced value of3.0T MRI and Muti-slice CT in the Diagnosis of HepatocellularCarcinomaObjective: To evaluate the dynamic contrast-enhanced value of3.0T MRI anmuti-slice CT in the diagnosis of hepatocellular carcinoma.Materials and Methods:21patients with the hepatocellular carcinoma wercollected from the First Affiliated Hospital of Soochow University during the period oFebruary2012to February2013. All the lesions were proved by operation or puncturpathology. They were performed with muti-slice CT and3.0T MRI, including conventionaMRI imaging and LAVA (1iver acquisition with volume acceleration) dynamic contrasenhanced scan. Observed the diagnostic sensitivity, specificity, accuracy in CT and MRIThe rates of demonstrating characteristic enhancement, artery and vein of the lesions in Cand MRI were also analyzed.Results:①30lesions in21patients were proved the hepatocellular carcinoma boperation or puncture pathology.②The diagnostic sensitivity, specificity, accuracy in Cand MRI were as follows, respectively,86.7%,86.7%,85.8%and96.7%,90.9%,90.4%③The rate of demonstrating characteristic enhancement in CT was36.7%(11/30), wherea50.0%(15/30)in LAVA dynamic contrast enhanced scan. The peak time in CT were all ilate arterial phase. While the peak time in LAVA were different from CT, with zero in earlarterial phase,2in medium arterial phase and13in late arterial phase.④The rates odemonstrating artery of the lesions in CT and MRI were53.3%(16/30) and73.3%(22/30 respectively, with vein of the lesions10%(3/30) and56.7(17/30) respectively, vesselsaround the lesions50%(15/30) and66.7%(20/30) respectively.Conclusion: Compared with MSCT, hepatocellular carcinoma are found in earlierstages in the LAVA dynamic contrast-enhanced scan. More comprehensive enhancementpattern and subtle patterns are also found, which lead to significant diagnostic values ofHCC.PartⅡ The Application study on DWI monoexponential andbiexponential Signal decay Analysis in the Diagnosis of HepatocellularCarcinomaObjective: To evaluate mono-exponential decay model and bi-exponential decaymodel in the diagnosis of hepatocellular carcinoma.Materials and Methods:28patients with the hepatocellular carcinoma werecollected from the First Affiliated Hospital of Soochow University during the period ofFebruary2012to February2013. All the lesions were proved by operation or puncturepathology. They were performed with conventional MRI imaging and diffusion-weightedimaging. The b-value of DWI was0,20,50,100,200,400,600,1000,1500,2000s/mm2respectively. The ADC(apparent diffusion coefficient) values in mono-exponential decaymodel and ADCst(standard apparent diffusion coefficient), ADCslow(slow apparent diffusioncoefficient), ADCfast(fast apparent diffusion coefficient), ffast(fraction of fast ADC) inbi-exponential decay model of the lesions were measured through the reconstruction ofADC map, ADCslowmap, ADCfastmap and fraction of fast ADC using the workstation. Tocompare the differences of ADC values of different degrees of differentiation in low,medium and high b-values respectively. To compare the differences of ADCst, ADCslow,ADCfast, ffastvalues in different degrees of differentiation. The correlativity was analyzedbetween the ADC, ADCst, ADCslow, ADCfast, ffastvalues and different degrees ofdifferentiation.Results:①There were significant differences in the SNR in DWI among diffrerent bvalues in abnomal and nomal tissues. There were significant negative correlation between b value and, SNR(Signal-to-Noise ratio) in abnomal tissues(r=-0.708, P<0.01). There weresignificant negative correlation between b value and SNR in nomal tissues(r=--0.572,P<0.01).②There were significant differences among the ADC values in different degreesof differentiation of hepatocellular carcinama in middle and high b-value groups(P<0.05).Significant positive correlations were found between the ADC value and the degree ofdifferentiation in middle(r=0.377，P<0.01) and high b-value group(r=0.815，P<0.01). Therewere no significant differences among the ADC values in different degrees ofdifferentiation of hepatocellular carcinama in low b-value group.③There were significantdifferences among the values of ADCst, ADCslow, ADCfastin different degrees ofdifferentiation of hepatocellular carcinama. Significant positive correlations were foundbetween the values of ADCstand the degree of differentiation(r=0.932， P<0.01).Significant positive correlations were found between the values of ADCslowand the degreeof differentiation(r=0.943，P<0.01). Significant positive correlations were found betweenthe values of ADCfastand the degree of differentiation(r=0.938，P<0.01). There were nosignificant differences among the values of ffastin different degrees of differentiation ofhepatocellular carcinama.Conclusion:①DWI, with no contast agent and higher specificity, can find themorphological changes before physiological changes by detecting the ability of thediffusion of water molecules in human tissue.②The quantification of ADC values inmono-exponential decay model has some values in the distinction of different degrees ofdifferentiation of hepatocellular carcinoma, but it is less stable.③The parameters inbi-exponential decay model can provide new and unique information in the distinction ofdifferent degrees of differentiation of hepatocellular carcinoma.