关键词: 肝脏肿瘤, 恶性, 增强磁共振, 定量参数, 诊断

Abstract: Objective The aim of this study was to explore the performance of quantitative parameters by dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) in the diagnosis of benign and malignant hepatic space-occupying lesions. Methods A total of 88 patients with hepatic space-occupying lesions confirmed by histopathological examination after surgery or fine needle aspiration biopsy were encountered in our hospital between February 2019 and February 2022. The histopathological results showed that there were 47 patients with benign hepatic lesions and 41 patients with liver cancer. All patients underwent DCE-MRI scanning to measure the mean enhancement time (MET), positive enhancement integral (PEI), maximum slope of increase (MSI) and maximum slope of decrease (MSD). The liver tissue Cripto-1, Kruppel-like factor (KLF4), homolobox A9(HOXA9) and transmembrane protein 3(IFITM3) mRNA levels were detected by fluorescence quantitative polymerase chain reaction (PCR). The diagnostic efficacy of parameter was evaluated by the area under the receiver operating characteristic (ROC) curve (AUC). Results The MET, PEI and MSI in the malignant lesions were (516.5±40.2)s,(32.4±6.3) and (99.6±17.8), all significantly lower than [(574.3±50.9)s,(256.7±22.7) and (271.6±25.3), respectively, P<0.05], while the MSD was (114.6±14.2), significantly higher than [(85.4±10.9), P<0.05] in the benign lesions; the Cripto-1 and IFITM3 mRNA levels in the malignant lesions were (130.3±17.5) and (141.8±19.2), both significantly higher than [(101.5±14.2) and (103.5±13.6), respectively, P<0.05], while the KLF4 and HOXA9 mRNA levels were (70.4±8.6) and (65.7±6.9), both significantly lower than [(99.8±12.6) and (98.8±11.4), respectively, P<0.05] in benign lesions; the ROC analysis showed that the AUC was 0.900, with the sensitivity of 96.0％, and the specificity of 80.0％, when the MET, PEI, MSI and MSD combination (equal to or greater than 534.7 s, 77.9, 136.8 and 100.5, respectivyly, as the cut-off-value) in predicting intrahepatic malignant lesions, superior to any parameter of them (P<0.05). Conclusion The quantitative parameters obtained by DCE-MRI scan are helpful for differential diagnosis of benign and malignant hepatic space-occupying lesions, which warrants further investigation.

Key words: Hepatoma, Benign and malignant lesions, Dynamic contrast-enhanced magnetic resonance imaging, Quantitative parameters, Diagnosis