| Objective To discuss the values of diffusion-weighted imaging?DWI?about hepatocellular carcinoma?HCC?prognosis factors,using apparent diffusion coefficient?ADC?to make preoperative assessment about hepatocellular carcinoma pathological grading and microvascular invasion.Finaly,to investigate the correlations between the minimum and mean values of and pathological grade and microvascular invasion?MVI?.Materials and Methods Preoperative magnetic resonance imaging?MRI?images of 364 patients with HCC confirmed by pathology were retrospectively analyzed.All patients underwent preoperative diffusionweighted imaging on a 1.5T MRI scanner.The pathological grade and imaging information were all complete in 241 cases,and the tumor microvascular invasion and imaging information were all complete in 321 cases.The mean and minimum ADC values of the tumors were measured.The ADC values were compared in tumors with different grades and the correlations between ADC values and pathological grade were analyzed.At the same time,the mean and minimum ADC values were compared between HCCs with MVI and those without MVI.Receiver operating characteristic?ROC?curves of ADC values were obtained and compared to distinguish poorly and nonpoorly differentiated HCCs and HCCs with MVI and those without MVI.Interobserver agreements were assessed by intraclass correlation coefficient?ICC?.Results The ICC for the measurements of the mean and minimum ADC values was 0.92?95% confidence interval [CI] 0.90–0.93?and 0.91?95% CI0.89–0.93?,respectively.The mean and minimum ADC values of poorly differentiated HCCs were lower than those of nonpoorly differentiated HCCs?P= 0.000,0.000,respectively?.The mean ADC values of poor-,moderate-,and well-differentiated HCCs were 0.92×10-3mm2/s,1.12×10-3mm2/s,and 1.13×10-3mm2/s,while their minimum ADC values were 0.78×10-3mm2/s,0.98×10-3mm2/s and 1.04×10-3mm2/s,respectively.The mean and minimum ADC values were negatively correlated with pathological grade?rs= –0.180 and –0.202,respectively??P =0.005,0.002,respectively?.For the differentiation between poorly and nonpoorly differentiated HCCs,the mean ADC value provided a sensitivity of 69.57% and a specificity of73.39% with a cutoff value of 0.96×10-3mm2/s while the minimum ADC value showed a sensitivity of 78.26% and a specificity of 61.47% with a cutoff value of0.90×10-3mm2/s.No significant difference existed between both ROC curves?P =0.64?.There were 67 HCCs with MVI and 254 HCCs without MVI.The mean and minimum ADC values of HCCs without MVI were 1.142×10-3mm2/s and0.984×10-3mm2/s,while those of HCCs with MVI were 1.033×10-3mm2/s and0.871×10-3mm2/s,respectively.The mean and minimum ADC values of HCCs with MVI were much lower than those of HCCs without MVI?P<0.05,respectively?.With a cut-off of 0.925×10-3mm2/s,the minimum ADC value provided a sensitivity of61.4% and a specificity of 65.7% in the prediction of MVI,while the mean ADC value provided a sensitivity of 71.7% and a specificity of 65.2% with a cut-off of1.015×10-3mm2/s.Conclusion DWI of HCC could preoperatively provide quantitative parameters for predicting tumor histological grade and Microvascular invasion. |
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