A Correlation Study Between DCE-MRI And Histopathology Grading Of Hepatocellular Carcinoma

Objective: To research the relationship between the characteristics of Dynamic Contrast Enhanced Magnetic Resonance Imaging(DCE-MRI) and histopathology grading of hepatocellular carcinoma(HCC). To explore the value of DCE-MRI to assess the histopathogy grading of HCC.Materials and Methods:1. Case data: We chose 35 cases of HCC for treatment in December 2013 to October 2014 in Fujian Union Hospital. Aged 37-66, with an age of 51.8 years on average. All cases were diagnosed by surgeries or biopsies.2. MR technology and image post-processing: 35 patients with HCC underwent conventional MR scanning and DCE-MRI, liver acquisition with volume acceleration(LAVA) was used in DCE-MRI and continuous scanning of 3 phases after Gd-BOPTA injection. Using Functool automatic analysis software of the GE ADW4.5 workstation, we analyzed the time-signal intensity curve(TIC) of tumor and normal liver in different phases and multiple quantization parameters.(1)TIC types of HCC: TIC were divided into three types for the 35 cases of HCC: typeⅡ(slowly rising type), type Ⅲ(speed up flat type), type Ⅳ(speed up falling type);(2)Parameters which can reflect the DCE-MRI characteristics of HCC: Maximum Slope of Increase(MSI), Signal Enhanced Ratio(SER), Signal Enhanced Extent(SEE), Time to Peak( TTP) and Signal Intensity of Peak(SIpeak).3. Histopathology grading: According to the Edmondson-Steiner grading system, we classified the 35 cases of HCC into grade Ⅰ-Ⅳ based on the degree of tumor differentiation, karyoplasmicratio and cellular atypia.4. Statistical analysis: All the data were analyzed using SPSS statistical analysis software(Version 20.0).(1)We use Kruskal-Wallis H and the Mann-Whitney U nonparametric tests to analyze the diagnostic efficacy between Ⅰ-Ⅳ TIC to assess the histopathology grading of HCC;(2)We use single factor analysis of variance and Kruskal-Wallis H nonparametric test to analyze the differences of DCE-MRI parameters in grade Ⅰ-Ⅳ HCC;(3)We use the Spearman correlation method to analyze the correlation between DCE-MRI parameters and histopathology grading of HCC.Results:1. Contrast of TIC types and histopathology grading of HCC: Within the 35 cases of HCC, 7 cases show type Ⅱ, 16 cases show type Ⅲ, 12 cases show type Ⅳ. No case show type Ⅰ. For the histopathology, 3 cases of grade Ⅰ, 9 cases of grade Ⅱ, 16 cases of grade Ⅲ, 7 cases of grade Ⅳ. TIC types can reflect the histopathology. We can see significant difference between type Ⅱ and type Ⅲ(P<0.05), type Ⅱ and type Ⅳ(P<0.01), type Ⅲ and type Ⅳ(P<0.05).Moreover, there was no significant difference of TIC type between grade Ⅰ and grade Ⅱ, gradeⅠ and grade Ⅲ, grade Ⅱ and grade Ⅲ(P>0.05). Histopathology grading cannot decide the TIC type definitely.2. Contrast of DCE-MRI parameters and histopathology grading of HCC: Quantization parameters of MSI, SER, SEE, TTP, SIpeak have correlation with histopathology grading of HCC(The correlation coefficients are0.938, 0.797, 0.938,-0.93, 0.845, P<0.01). HCC which has higher value of MSI, SER, SEE, SIpeak and lower value of TTP has higher histopathology grading-s(P<0.01). Any two gradings can be identified from grade Ⅰ-Ⅳ, according to the value of MSI, SER, SEE, TTP, SIpeak.Conclusions:1. TIC types can reflect the histopathology.2. Histopathology grading cannot decide the TIC type definitely.3. DCE-MRI parameters of MSI, SER, SEE, TTP, SIpeak have correlation with histopathology grading of HCC. Any two gradings can be identified from grade Ⅰ-Ⅳ, according to the parameters above.