| Objective:To investigate the value of magnetic resonance 3D-Dixon imaging based on chemical shift effects and diffusion weighted imaging?DWI?in assessing the prognostic factors of hepatocellular carcinoma?HCC?,using fat fraction?FF?and minimum apparent diffusion coefficient(ADCmin)to evaluate the pathological grading of hepatocellular carcinoma before operation,and explore the correlation between tumor FF and ADCmin values and pathological grade of HCC,respectively.Materials and Methods:We retrospectively analyzed preoperative MRI data of109 patients with hepatocellular carcinoma confirmed by pathology in our hospital from January 2016 to December 2017.MRI examinations included routine T1WI,T2WI plain scans,DWI and 3D-Dixon sequences,and multiple phase enhancement scans.Intratumoral fat fraction and ADCmin values were measured by chemical shift with In/Opposed-phase?IOP?and DWI sequences,respectively.The differences in the FF and ADCmin values of solid components in HCC tumors with different pathological differentiation levels were compared,and the correlations between FF and ADCmin values and pathological grades were analyzed.Application of ROC curve to determine the differential value,sensitivity and specificity of FF and ADCminin values in different pathological grades.Results:A total of 109 patients were included in this study,24 in the poorly differentiated group,69 in the moderately differentiated group,and 16 in the highly differentiated group.In poorly,moderately and highly differentiated HCC,the FF of tumor solid part was 10.41%,8.06%and 4.67%,respectively.The FF of poorly differentiated HCC is higher than that of moderately differentiated and highly differentiated HCC?P<0.01?.The FF of moderately differentiated HCC is higher than that of highly differentiated HCC?P<0.01?.There was a positive correlation between FF and pathological grade?r=0.566,P<0.01?.FF identified 8.71%for the poorly differentiated and moderately differentiated,the sensitivity was 75.0%,the specificity was 67.19%,the area under the ROC curve was 0.738;The cutoff for moderately differentiation and highly differentiation was 5.53%,the sensitivity was 71.87%,the specificity was 75.0%,and the area under the ROC curve was 0.843.The ADCminin values of solid,poorly,moderately,and highly differentiated HCC tumors were0.318×10-3mm2/s,0.449×10-3mm2/s,and 0.605×10-3mm2/s,respectively.The ADCminin values of poorly differentiated HCC was lower than that of moderately differentiated and highly differentiated HCC?P<0.01?;the ADCmin values of moderately differentiated HCC was lower than that of highly differentiated HCC?P<0.01?.There was a negative correlation between ADCmin values and pathological grade?r=-0.674,P<0.01?.The ADCmin values predicts the cut-off value of poorly differentiation and moderately differentiation is 0.379×10-3mm2/s,the sensitivity is 79.17%,the specificity is 84.37%,the area under the ROC curve is 0.890,and the cut-off value for predicting moderately differentiation and highly differentiation is 0.532×10-3mm2/s,the sensitivity was 89.06%,the specificity was 62.50%,and the area under the ROC curve was 0.812.Conclusion:3D-Dixon and DWI play an important role in the diagnosis and prognostic factors of hepatocellular carcinoma.Fat fraction and minimum ADC values are significantly correlated with HCC pathological grading,and can be used as noninvasive biological indicators to evaluate histopathological factors of hepatocellular carcinoma. |
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