| Objective:To investigate the MRI technique based on the sequences of IDEAL-IQ?iterative decomposition of water and fat with echo asymmetry and least squares quantification sequence?and Diffusion weighted imaging?DWI?sequences in differentiation degree of hepatocellular carcinoma,respectively,using Fat fraction?Fat fraction?,R2*value and minimum apparent diffusion coefficient of ADC of HCC pathologic differentiation degree assessment before surgery,and respectively discusses tumor Fat fraction solid composition,iron content,and the minimum ADC values and HCC pathologic differentiation degree of correlation.Materials and Methods:A retrospective analysis of 20 patients with hepatocellular carcinoma admitted to our hospital from January 2018 to December 2018 was conducted.None of the enrolled patients received any clinical treatment?including radiofrequency ablation,interventional therapy,chemotherapy,etc.?before MRI.MRI scanning sequences included conventional plain scanning T1WI and T2WI sequences,DWI sequences,IDEAL-IQ sequences,and multiphase enhanced scans.The imaging characteristics of HCC on all sequences including IDEAL-IQ and DWI were analyzed by imaging physicians with at least 5 years of experience in imaging diagnosis,and the values of intratumor fat fraction,R2*and the minimum ADC were measured.The pathological classification of all HCC lesions was divided into well,moderately and poorly differentiation groups according to the Edmondon-Steiner classification method,and the differences of the fat fraction value,R2*value and the minimum ADC value of solid the differences in fat scores,R2*values,and minimum ADC values in HCC tumors with different degrees of differentiation were compared;their correlation with pathological grades was analyzed.The ROC curve was used to determine the discriminant boundary values of the above indicators under different degrees of differentiation,and the sensitivity and specificity were determined fat fraction value,R2*value and minimum ADC value and pathological grade was analyzed.ROC curve was used to determine the fat fraction,R2*value and the minimum ADC value of different pathological grades to identify the boundary value,sensitivity and specificity,and then to evaluate the diagnostic efficacy of the fat fraction value,R2*value and the minimum ADC value to estimate the degree of histopathological differentiation of HCC.Results:A total of 37 patients were selected according to the study requirements and grouped by pathological examination results.Among them,10 cases were in the poorly differentiated group,accounting for 27.0%;20 cases in the moderately differentiated group,accounting for 54.1%;and 7 cases in the highly differentiated group,accounting for 18.9%.From the fat fraction of HCC tumor,the low-differentiation group was3.05%;the moderately differentiated group was 5.15%;and the highly differentiated group was 8.23%.The fat fractions of low,medium and high differentiation HCC tumors were 3.05%,5.15%and 8.23%,respectively.Three groups of this index were compared,among which the low-differentiation group was the lowest,and the difference was significant?P<0.01?.The middle-differentiated group was significantly lower than the highly differentiated group.The difference was significant?P<0.01?.The body fat fraction of HCC tumor was positively correlated with the degree of pathological differentiation?r=0.667,P<0.01?.The fat fraction was evaluated as 3.890for poorly differentiated and moderately differentiated,80.0%for sensitivity,80%for specificity,and 0.805 for ROC curve.The fat fraction was predicted to be 6.195 for differentiation and differentiation.The sensitivity was 100%,specificity is 70%,and the area under the ROC curve is 0.879.The minimum ADC values of low,medium and high-differentiation HCC tumor tumors were 0.289×10-3mm2/s,0.416×10-3mm2/s,and0.538×10-3mm2/s,respectively.From the minimum ADC value of HCC tumor tumor,the low-differentiation group was 0.289×10-3mm2/s;the moderately differentiated group was 0.416×10-3mm2/s;in the highly differentiated group,it was 0.538×10-3mm2/s.Three groups of this index were compared,among which the low-differentiation group was the lowest,and the difference was significant?P<0.01?.The middle-differentiated group was significantly lower than the highly differentiated group.The difference was significant?P<0.01?.It can be seen that the minimum ADC value is closely related to the degree of pathological differentiation with the degree of pathological differentiation?r=0.669,P<0.01?.The minimum ADC was used to evaluate the differentiation thresholds of different differentiation degrees,and the sensitivity and specificity were determined.The results showed that the low and medium differentiation thresholds were 0.381×10-3 mm2/s,sensitivity of 75%,specificity of 100%,and area under the ROC curve of 0.925.The median differentiation and differentiation threshold is 0.521.×10-3 mm2/s,The sensitivity is 71.43%,the specificity is 90%,and the area under the ROC curve is 0.779.The R2*values of low,medium and highly differentiated HCC tumor tumors were 20.678HZ,24.407HZ,and 33.271,respectively.The R2*value of poorly differentiated HCC was lower than that of highly differentiated HCC?P=0.01?;the value of moderately differentiated HCC R2*was lower than that of highly differentiated HCC?P=0.01?.The R2*value was positively correlated with the degree of pathological differentiation?r=-0.581,P<0.01?.The R2*value was estimated to be23.738HZ for low-and moderate-differentiation,55%for sensitivity,90%for specificity,and 0.685 for ROC curve.The median for differentiation and differentiation was 29.901HZ,sensitivity.The medium and high differentiation threshold was29.901HZ,the sensitivity was 85.71%,the specificity was 75%,and the area under the ROC curve was 0.864.Conclusion:Fat fraction,R2*value and minimum ADC value are significantly correlated with the degree of HCC differentiation,and can be used for pathological evaluation of hepatocellular carcinoma under non-invasive conditions. |
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