Intravoxel Incoherent Motion Quantitative Parameters Combined with Pathological Grading for Assessing the Survival Prognosis of Hepatocellular Carcinoma
10.3969/j.issn.1005-5185.2025.03.007
- VernacularTitle:体素内不相干运动定量参数联合病理评估肝细胞癌的生存预后
- Author:
Xuelian SHI
1
;
Yingmin ZHAI
;
Hui LIU
;
Jiangyang PAN
;
Ning ZHANG
;
Gaofeng SHI
Author Information
1. 河北医科大学第四医院疼痛科,河北 石家庄 050011
- Publication Type:Journal Article
- Keywords:
Carcinoma,hepatocellular;
Magnetic resonance imaging;
Diffusion weighted imaging;
Intravoxel incoherent motion;
Risk factors;
Prognosis
- From:
Chinese Journal of Medical Imaging
2025;33(3):260-266
- CountryChina
- Language:Chinese
-
Abstract:
Purpose To explore the predictive value of intravoxel incoherent motion quantitative parameters and pathological grading for the survival prognosis of patients with hepatocellular carcinoma(HCC)after surgery.Materials and Methods A retrospective analysis was performed on 65 patients with HCC who had complete imaging data and underwent radical surgery at the Fourth Hospital of Hebei Medical University from October 2018 to November 2019.All patients were followed up for a 5-year survival period.The receiver operating characteristic curve was used to determine the optimal cut-off values for intravoxel incoherent motion quantitative parameters,including standard apparent diffusion coefficient(sADC),diffusion coefficient(D),pseudo-diffusion coefficient(D*)and perfusion fraction(F).Univariate and multivariate Cox regression analyses were performed to select independent predictive factors affecting the overall survival time of HCC patients after surgery.Results Univariate Cox regression analysis showed that pathological grading(HR=1.588,95%CI 0.936-2.692,P=0.086),microscopic vascular invasion(HR=2.512,95%CI 1.308-4.823,P=0.006),neutrophil-to-lymphocyte ratio(HR=1.752,95%CI 1.000-3.068,P=0.050),sADC(HR=0.433,95%CI 0.235-0.796,P=0.007),D(HR=0.262,95%CI 0.121-0.565,P<0.001)and F(HR=2.268,95%CI 1.259-4.087,P=0.006)were all prognostic factors.Multivariate Cox regression analysis showed that pathological grade(grade Ⅲ and Ⅳ)was the independent risk factor for the survival prognosis of patients after HCC surgery(HR=1.748,95%CI 1.003-3.045,P=0.049);the D value>0.916×10-3 mm2/s was the independent protective factor for their survival prognosis(HR=0.249,95%CI 0.113-0.550,P<0.001).Conclusion The pathological grade(Ⅲ/Ⅳ)as an independent risk factor and higher D values as a protective factor are the independent predictors of survival and prognosis of patients with HCC after surgery,and the combination of the two can provide a reference for clinical prognosis assessment.
