摘要：The present study aimed to investigate the value of intravoxel incoherent motion diffusion weighted imaging (IVIM-DWI) in the preoperative prediction of the histologic differentiation of hepatocellular carcinoma (HCC). Seventy HCC patients were scanned with a 3.0 T magnetic resonance scanner. The values of apparent diffusion coefficient (ADC), slow apparent diffusion coefficient (D), fast apparent diffusion coefficient (D*), and the fraction of the fast apparent diffusion coefficient (f) were measured. Analysis of variance was used to compare the differences in parameters between groups with different degrees of histologic differentiation.
p < 0.05 was considered statistically significant. Receiver operating characteristic (ROC) curves were used to analyse the efficacy of IVIM-DWI parameters for predicting the histologic differentiation of HCC. The ADC and D values for well, moderately and poorly differentiated HCC were 1.35 ± 0.17 × 10
−3 mm
2/s, 1.16 ± 0.17 × 10
−3 mm
2/s, 0.98 ± 0.21 × 10
−3 mm
2/s, and 1.06 ± 0.15 × 10
−3 mm
2/s, 0.88 ± 0.16 × 10
−3 mm
2/s, 0.76 ± 0.18 × 10
−3 mm
2/s, respectively, and all differences were significant. The D* and f values of the three groups were 32.87 ± 14.70 × 10
−3 mm
2/s, 41.68 ± 17.90 × 10
−3 mm
2/s, 34.54 ± 18.60 × 10
−3 mm
2/s and 0.22 ± 0.07, 0.23 ± 0.08, 0.18 ± 0.07, respectively, with no significant difference. When the cut-off values of ADC and D were 1.25 × 10
−3 mm
2/s and 0.97 × 10
−3 mm
2/s, respectively, their diagnostic sensitivities and specificities for distinguishing well differentiated HCC from moderately differentiated and poorly differentiated HCC were 73.3%, 85.5%, 86.7%, and 78.2%, and their areas under the ROC curve were 0.821 and 0.841, respectively. ADC and D values can be used preoperatively to predict the degree of histologic differentiation in HCC, and the D value has better diagnostic value.
