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针对乙型肝炎相关的肝内胆固醇癌的MRI:一个多中心比较研究
Ruofan Sheng1,2,3, Heqing Wang3, Yunfei Zhang2,4
1Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai, 200032, China.
Journal of magnetic resonance imaging : JMRI
|June 13, 2023
概括
与乙型肝炎病毒 (HBV) 相关的肝脏内胆固醇癌 (iCCA) 呈现出诊断方面的挑战. 手术前的MRI特征,如洗模式和定义的边缘,可以帮助在HBV感染患者中区分iCCA.
科学领域:
- 肝病学 肝病学是一种肝病学.
- 放射学 放射学是一门学科.
- 在瘤学瘤学.
背景情况:
- 在乙型肝炎病毒 (HBV) 感染的患者中,由于重叠的症状和非典型的成像,肝脏内胆管癌 (iCCA) 的诊断很困难.
- 乙型肝炎病毒感染可以改变iCCA的临床和成像表现.
研究的目的:
- 识别和比较手术前磁共振成像 (MRI) iCCA在患有和没有HBV感染的患者的特征.
- 评估MRI在区分HBV相关的iCCA中的实用性.
主要方法:
- 在三所研究所对431名确诊iCCA的患者 (143名HBV阳性,288名HBV阴性) 的回顾性分析.
- 在HBV阳性和HBV阴性iCCA患者之间以及在HBV阳性iCCA和肝细胞癌 (HCC) 患者之间对MRI特征的比较.
- 使用后勤回归和接收器操作特征 (ROC) 分析开发和验证诊断模型.
主要成果:
- 洗或退化增强模式,明确的瘤边缘,以及没有周胆道扩张是HBV相关iCCA的独立预测因素.
- 这些特征也是HBV相关的HCC的特征.
- 综合MRI指数在训练队列中达到0.798的曲线下面积 (AUC),在验证队列中达到0.789的曲线下面积,灵敏度,特异性和精度超过70%.
结论:
- 在手术前的MRI可以有效地帮助在非HBV患者中区分与HBV相关的iCCA和iCCA.
- 特定的MRI特征对于在HBV感染的背景下区分iCCA至关重要.
- 开发的诊断模型在识别HBV相关的iCCA方面表现良好.
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