基于磁共振扩散加权成像的虚拟弹性成像在鉴别肝细胞癌和肝转移瘤中的应用研究

Virtual Elastography Based on MR-DWI for Differentiation of Hepatocellular Carcinoma and Hepatic Metastases

摘要: 目的：探讨基于磁共振扩散加权成像的虚拟弹性成像(virtual magnetic resonance elastography, vMRE)在鉴别肝细胞癌和肝转移瘤中的诊断效能。方法：收集2024年9月至2025年6月因肝脏占位性病变而就诊于青岛大学附属医院的患者，纳入了30例接受扩散加权成像磁共振检查。利用b值为200和1500 s/mm²的DWI图像，计算出了移位表观扩散系数与基于扩散的剪切模量(μdiff)，并根据b值为0和800 s/mm²的DWI图像获取ADC值，并比较二者在鉴别肝细胞癌(HCC)与肝转移瘤的能力。结果：本研究一共纳入了30例患者(男性23例，女性7例，平均年龄56.1 ± 10.9岁)。结果显示，肝细胞癌与肝转移瘤的ADC值无统计学显著性差异(p = 0.2764)，肝细胞癌与肝转移瘤之间的μdiff值存在显著的统计学差异(p < 0.01)，且HCC的μdiff值低于肝转移瘤。结论：与传统表观扩散系数相比，磁共振虚拟弹性成像在鉴别肝细胞癌与肝转移瘤方面具有更优越的性能。

Abstract: Objective: To evaluate the diagnostic performance of virtual magnetic resonance elastography (vMRE) in differentiating between hepatocellular carcinoma (HCC) and hepatic metastases. Methods: Thirty patients with space-occupying liver lesions who attended The Affiliated Hospital of Qingdao University from September 2024 to June 2025 were enrolled, and all participants underwent diffusion-weighted magnetic resonance imaging (DWI). The shifted apparent diffusion coefficient and the diffusion-based shear modulus (μdiff) were calculated by using the DW images of b values of 200 and 1500 s/mm2. And ADC values were obtained from DWI images with b-values of 0 and 800 s/mm². The obtained μdiff and ADC values were compared to evaluate their diagnostic ability in differentiating hepatocellular carcinoma from hepatic metastases. Results: This study included 30 patients (23 males, 7 females, mean age 56.1 ± 10.9 years). Our results showed no statistically significant difference in ADC values between hepatocellular carcinoma and hepatic metastases (p = 0.2764). Quantitative analysis showed a statistically significant difference in μdiff values between HCC and hepatic metastases, and HCC exhibited lower μdiff values compared to hepatic metastases (p < 0.01). Conclusion: Compared with conventional apparent diffusion coefficient, magnetic resonance virtual elastography demonstrates superior performance in differentiating hepatocellular carcinoma from liver metastases.