Hepatosellüler karsinomun tanısal ayrımında manyetik rezonans görüntülemede difüzyon tensör görüntüleme ve difüzyon ağırlıklı görüntülemenin katkısı
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Dosyalar
Tarih
2020
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Yayıncı
Trakya Üniversitesi, Tıp Fakültesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Bu çalışmanın amacı difüzyon tensör görüntüleme ve difüzyon ağırlıklı görüntülemenin hepatosellüler karsinomun tanısal ayrımında katkısını sağlıklı ve sirotik parankim özellikleriyle karşılaştırarak hesaplamaktır. Ocak 2019 ile Aralık 2019 tarihleri arasında Trakya Üniversitesi Tıp Fakültesi Radyoloji Anabilim Dalında hepatosellüler karsinom ön tanısıyla manyetik rezonans görüntüleme ile tetkik edilen ve tetkiklerinde radyolojik, klinik ve/veya histopatolojik olarak hepatosellüler karsinom tanısı alan 62 hasta, klinik ve/veya histopatolojik olarak siroz tanısı alan 56 hasta ve sağlıklı 52 olgu çalışmaya dahil edildi. Kantitatif verilerden fraksiyonel anizotropi ve apparent diffusion coefficient değerleri hesaplandı. Hepatosellüler karsinomlu olgularda sayı, tümoral patern, boyut, yağ, nekroz, kalsifikasyon, hemoraji, T1 hiperintensitesi, T2 hiperintensitesi, arteryel fazda kontrastlanma, geç fazda yıkanma, kapsüler kontrastlanma, görsel difüzyon kısıtlanması, satellit nodül, takipte büyüme, asit, vasküler invazyon, lenfadenopati ve sürrenal metastaz özellikleri değerlendirildi. Olguların demografik, klinik ve laboratuvar verileri otomasyon sisteminden kayıt altına alındı. Hepatosellüler karsinomlu olgularda lezyon apparent diffusion coefficient değerleri lezyon dışı parankime, sirotik parankime ve sağlıklı parankime göre anlamlı derecede düşük, fraksiyonel anizotropi değerleri anlamlı derecede yüksek bulunmuştur. Child Pugh ve Model For End-Stage Liver Disease skorlarındaki artış ile konvansiyonel apparent diffusion coefficient değerindeki düşüş arasında anlamlı ilişki saptanmıştır. Tedavi alan olgularda apparent diffusion coefficient değerleri düşük, fraksiyonel anizotropi değerleri yüksek bulunmuştur. Zeminde sirotik parankim olan ve olmayan hepatosellüler karsinomlu olgularda lezyonlar ve parankim değerleri arasında anlamlı farklılık izlenmedi. Hepatosellüler karsinom tanısında apparent diffusion coefficient ve fraksiyonel anizotropi değerlerinin lezyon dışı parankim, sağlıklı ve sirotik karaciğer ile ayrımda faydalı olduğu saptanmıştır. Bununla birlikte dinamik kontrastlı inceleme hepatosellüler karsinom tanısında önemini korumaktadır.
The aim of this study is to analyze the contribution of diffusion weighted and diffusion tensor imaging in hepatocellular carcinoma diagnosis and comparing them with healthy and cirrhotic parenchyma features. 62 patients diagnosed as hepatocellular carcinoma radiologically, clinically and / or histopathologically were included in the study who magnetic resonance imaging examination was performed between January 2019 and December 2019, at Trakya University Faculty of Medicine, Department of Radiology. Fractional anisotropy and apparent diffusion coefficient values were calculated from quantitative data. Tumor number, tumoral pattern, size, presence of fat necrosis calcification and hemorrhage, T1 hyperintensity, T2 hyperintensity, arterial phase enhancement, washout, capsular enhancement, visual diffusion restriction, satellite nodule, growth in follow-up, ascites, vascular invasion, lymphadenopathy and adrenal metastasis features were evaluated. Demographic data, clinical history and laboratory values were recorded from the automation system. Apparent diffusion coefficient values were significantly lower and fractional anisotropy values were significantly higher compared to non-cancerous liver parenchyma, cirrhotic parenchyma and healthy parenchyma in the patients with hepatocellular carcinoma. A significant correlation was found between the increase in Child Pugh and Model For End- Stage Liver Disease scores and the decrease in apparent diffusion coefficient value in diffusion weighted imaging. Apparent diffusion coefficient values were lower and fractional anisotropy values were higher in patients receiving treatment. In patients with hepatocellular carcinoma without evidence of cirrhosis, there was no significant difference in lesion and parenchyma values compared with patients with hepatocellular carcinoma in presence of cirrhosis. In the diagnosis of hepatocellular carcinoma, apparent diffusion coefficient and fractional anisotropy values were found to be useful in differentiation with non-cancerous liver parenchyma, healthy and cirrhotic liver. Dynamic contrast-enhanced imaging remains important in the diagnosis.
The aim of this study is to analyze the contribution of diffusion weighted and diffusion tensor imaging in hepatocellular carcinoma diagnosis and comparing them with healthy and cirrhotic parenchyma features. 62 patients diagnosed as hepatocellular carcinoma radiologically, clinically and / or histopathologically were included in the study who magnetic resonance imaging examination was performed between January 2019 and December 2019, at Trakya University Faculty of Medicine, Department of Radiology. Fractional anisotropy and apparent diffusion coefficient values were calculated from quantitative data. Tumor number, tumoral pattern, size, presence of fat necrosis calcification and hemorrhage, T1 hyperintensity, T2 hyperintensity, arterial phase enhancement, washout, capsular enhancement, visual diffusion restriction, satellite nodule, growth in follow-up, ascites, vascular invasion, lymphadenopathy and adrenal metastasis features were evaluated. Demographic data, clinical history and laboratory values were recorded from the automation system. Apparent diffusion coefficient values were significantly lower and fractional anisotropy values were significantly higher compared to non-cancerous liver parenchyma, cirrhotic parenchyma and healthy parenchyma in the patients with hepatocellular carcinoma. A significant correlation was found between the increase in Child Pugh and Model For End- Stage Liver Disease scores and the decrease in apparent diffusion coefficient value in diffusion weighted imaging. Apparent diffusion coefficient values were lower and fractional anisotropy values were higher in patients receiving treatment. In patients with hepatocellular carcinoma without evidence of cirrhosis, there was no significant difference in lesion and parenchyma values compared with patients with hepatocellular carcinoma in presence of cirrhosis. In the diagnosis of hepatocellular carcinoma, apparent diffusion coefficient and fractional anisotropy values were found to be useful in differentiation with non-cancerous liver parenchyma, healthy and cirrhotic liver. Dynamic contrast-enhanced imaging remains important in the diagnosis.
Açıklama
Anahtar Kelimeler
Hepatosellüler Karsinom, Manyetik Rezonans Görüntüleme, Difüzyon Tensör Görüntüleme, Difüzyon Ağırlıklı Görüntüleme, Hepatocellular Carcinoma, Magnetic Resonance Imaging, Diffusion Tensor Imaging, Diffusion Weighted Imaging
