Application Of Magnetic Resonace DKI,IVIM And DWI Techniques In The Evaluation Of Pathological Grading Of Primary Hepatocellular Carcinoma

The first part: INVESTIGATION OF PHC GRADING: MAGNETIC RESONACE DIFFUSION KURTIOSIS IMAGING VERSUS CONVENTIONAL DIFFUSION WEIGHTED IMAGINGObjective To investigate the correlation between diffusion kurtosis imaging(DKI)and diffusion weight imaging(DWI)parameters the value of MD?MK?ADC and pathologic grading of primary hepatocellular carcinoma(PHC),and compare the size of their relevance.Materials and Methods Magnetic resonance imaging examination(including routine plain scan,dyn-amoic enhanced scan,DWI sequence,DKI sequence)and surgical treatment were performed in60 patients with clinically suspected hepatocellular carcinoma-a.Histological grading of the resected tumor tissue was performed in 39 patients who met the condition.The pathological grades of primary hepatocellular carci-noma were grade ?,?,? and ?,and the MD,MK and ADC values of DKI and DWI were obtained by subtable software.SPSS20.0software was used to analyze the variance and correlation analysis of MD value,MK value and ADC value and Pathological Grade of primary hepatocellular carcinoma(PHCC).Results 39 cases of primary hepatocellular carcinoma of the liver pathology include: ? grade 7 cases,? grade 15 cases,? grade 13 cases,IV grade 4 cases.The ADC,MK and MD values of grade ? lesions were(1.38±0.35)×10-3mm2/s,0.84± 0.18,(1.04±0.21)×10-3mm2/s,respectively,the grade?was(1.24±0.18)×10–3mm2/s,1.05±0.10,(0.89±0.19)×10–3mm2/s;respectively,the grad ? was(1.11±0.12)×10 –3mm2/s,1.26±0.11,(0.73±0.15)×10–3mm2/s respectively,the grad ? was(1.01 ±0.06)×10–3mm2/s,1.56±0.08,(0.59±0.09)×10–3mm2/s.MD,MK,ADC value was significantly different(p?0.001)in different PHCC pathological.With the decr-eese of pathological differentiation,the MD and ADC values decreased gradual-ly,the MK value increased gradually.The correlation coefficients betwe-en the values of MD,ADC,MK and the pathological grading of primary hepatocellular carcinoma were-0.372,-0.558 and 0.811,respectively.Conclusion The correlation between MD value,ADC value and the PHC of pathological classification is weak,and were negatively correlated with pathologic grade.The correlation between MK value and the PHC of pathological is stronger,and was positive correlated with pathological degree.So,The value of MK is helpful to pathological degree preoperative assessment.The second part: INVESTON OF PHC GRADING:INTRAVOXEL INCOHERENT MOTION MRI VERSUS CONVENTIONAL DIFFUSION WEIGHTED IMAGINGObjective To study the correlation between the parameters obtained by Intravoxel Incoherent Motion IVIM and the pathological grade of primary hepatocellular carcinoma(PHC)and to compare with the traditional diffusion-weighted imaging(Diffusion-weighted imaging,DWI)from the ADC.Method 35 patients were enrolled in my study of liver biopsy,dynamic enhancement,DWI and 7 b-values IVIM scans(b=0~800s/mm2).35 patients were diagnosed as PHC by postoperative pathology and making the pathological grading.The apparent diffusion coefficient value were calculated by using the single exponential model.The D value(true diffusion coefficient),D* value(Perfusion diffusion coefficient or fake diffusion coefficient),f value(perfusion fractio-n)were calculated by using the IVIM model of the double exponenttial model.and.The non-parametric Mann-Whitney test was used to analyze the diff-erences of ADC values,D,D* and f values in different pathological grades of PHC.The histological grade of PHCC was analyzed by box diagram.The relat-ionship between the parameters of the relationship between the use of correlate-on analysis of statistical parameters obtained by the correlation between the pa-rameters and pathological grading.Result The pathological grade of primary hepatocellular carcinoma grade?5 cases,?grade11,grade ?9cases,?3cases.The values of ADC,D,D*of PHCC pathological grade?were resceptively(1.3±0.26)×10-3mm2/sec,(1.32±0.29)×10-3mm2/sec,(33.7±21.0)×10-3mm2/sec,20.0±3.7;grade?wereresceptively(1.21±0.17)×10-3m m2/sec,(1.17±0.12)×10-3mm2/sec,(39.1±14.0)×10-3mm2/sec,25.1±11.9;grade ? were resceptively(1.11±0.13)×10-3mm2/sec,(1.01±0.12)×10-3mm2/sec,(30.5±18.3)×10-3mm2/sec,21.3±12.0;geade ?were resceptivel(1.01±0.06)×10-3 mm2/sec,(0.89±0.09)×10-3mm2/sec,(34.2±15.3)×10-3mm2/sec,16.5±7.3.D* and f values were not significantly different from those of HCC(P>0.05).The corre-lation coefficient between the ADC and the pathological grade of PHCC r was-0.623.The correlation coefficient between the D value and the pathological grade of HCC was-0.769.The D value obtained from the irrelevant exercise in the voxel and the ADC value obtained by the traditional diffusion weighted imaging were statistically significant with the postoperative pathological grade of HCC.And D* value and f value and liver cancer pathological grade is not statistically significant The correlation between the value and the pathological grade of liver cancer was the strongest.