2022年 · 第102卷第03期

Angiomyolipoma (AML) is a benign tumor with rich blood supply to the liver that occurs in middle-aged women. The accurate rate of preoperative imaging diagnosis is only 20% ~52%. Especially, fat-deficient AML is most likely to be misdiagnosed as hepatocellular carcinoma (HCC). AML and HCC are treated in very different ways, and accurately distinguishing between the two can prevent AML patients from receiving unnecessary treatment due to misdiagnosis of HCC. To investigate the manifestations of fat-depleted AML on gadoxetate-enhanced MRI and to be able to accurately distinguish the imaging features of the two in low-risk HCC patients, this study included 12 patients with pathologically confirmed hepatic AML without risk factors for developing HCC from November 2004 to November 2013, and 27 patients with HCC were collected as controls according to the same inclusion criteria. Two radiologists analyzed and agreed on their respective morphological features, enhancement patterns, and hepatobiliary phase (HBP) manifestations. The results showed that AML was younger than HCC patients and mainly occurred in middle-aged women, while most HCC patients were elderly men; The most common patterns of enhancement were obvious enhancement in the arterial phase, hyposignal in the portal phase or transitional phase, but in the hepatobiliary phase, AML was more likely to exhibit uniform hyposignal than HCC, and the mean relative signal intensity between AML and spleen was lower than that of HCC.

High-grade serous ovarian cancer (HGSOC) is the most common and deadly histological subtype of ovarian cancer. First-line platinum chemotherapy after initial cytoreductive surgery is its standard treatment, but its recurrence rate after treatment is as high as 75%. The classification of platinum-sensitive and platinum-resistant patients with the presence or absence of recurrence at an interval of 6 months is very simple and effective, and can provide an objective basis for the subsequent individualized treatment plan selection. Diffusion-weighted imaging (DWI) can detect the integrity of cells and cell membranes using the apparent diffusion coefficient (ADC) to quantify the degree of diffusion of water molecules in tissues, while histograms based on ADC analysis can analyze tumor bioheterogeneity. This study predicted the chemotherapy response of patients with platinum drugs through ADC histogram analysis of the whole tumor area and the whole solid tumor area of the primary lesion of HGSOC in the pre-treatment stage. A total of 70 patients admitted between February 2011 and October 2018 were included in the study, including 33 platinum-sensitive patients and 37 platinum-resistant patients. Age, pretreatment cancer antigen 125 levels, IAOG stage, postoperative residual tumors, ADC histogram parameters based on whole tumor volume and based on tumor solid components were compared between platinum-resistant and platinum-sensitive groups. The results showed that there was no significant difference in clinical characteristics between platinum-sensitive patients and platinum-resistant patients; There were no statistically significant differences in ADC histogram-derived parameters based on total tumor volume between the two groups. The platinum-sensitive group had a significantly higher mean value of ADC based on tumor solid component histogram parameters and a significantly lower skewness and kurtosis compared to the platinum-resistant group. The prediction performance of ADC mean, skewness, and kurtosis were moderate, with areas under the curve of 0.667, 0.733, and 0.616, respectively. Skeewness became an independent risk factor for platinum resistance. It indicated that ADC histogram analysis of solid components of primary tumor was better than the whole tumor volume, and it had predictive value for platinum chemotherapy response in patients with advanced HGSOC.