Differential value of enhanced MRI combined with ADC between hepatic primary mucosa-associated lymphoid tissue lymphoma and hepatocellular carcinoma

XIE Junshi; LI Xiaoming; MOU Yong; CHEN Fan

doi:10.16016/j.2097-0927.202504103

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Differential value of enhanced MRI combined with ADC between hepatic primary mucosa-associated lymphoid tissue lymphoma and hepatocellular carcinoma

Monographic Reports | 更新时间：2025-09-11

- Differential value of enhanced MRI combined with ADC between hepatic primary mucosa-associated lymphoid tissue lymphoma and hepatocellular carcinoma
- Journal of Army Medical University Vol. 47, Issue 17, Pages: 2053-2060(2025)
- 作者机构：
  
  陆军军医大学（第三军医大学）第一附属医院放射科，重庆
- 作者简介：
  
  CHEN Fan， E-mail： chenfan199109@163.com
- 基金信息：
  
  the General Project of Natural Science Foundation of China(CSTB2022NSCQ-MSX1371)
- DOI：10.16016/j.2097-0927.202504103
  CLC： R445.2;R733.4;R735.7
- Received：30 April 2025，
  
  Revised：2025-08-04，
  
  Accepted：11 August 2025，
  
  Published：15 September 2025
- 稿件说明：
移动端阅览
谢俊诗，李晓明，牟勇，等.增强MRI联合表观弥散系数在肝原发性黏膜相关淋巴组织淋巴瘤与肝细胞癌中的鉴别诊断价值［J］.陆军军医大学学报，2025，47（17）：2053-2060.DOI：10.16016/j.2097-0927.202504103.

XIE J S，LI X M，MOU Y，et al.Differential value of enhanced MRI combined with ADC between hepatic primary mucosa-associated lymphoid tissue lymphoma and hepatocellular carcinoma［J］.J Army Med Univ，2025，47（17）：2053-2060.DOI：10.16016/j.2097-0927.202504103.
谢俊诗，李晓明，牟勇，等.增强MRI联合表观弥散系数在肝原发性黏膜相关淋巴组织淋巴瘤与肝细胞癌中的鉴别诊断价值［J］.陆军军医大学学报，2025，47（17）：2053-2060.DOI：10.16016/j.2097-0927.202504103. DOI：

XIE J S，LI X M，MOU Y，et al.Differential value of enhanced MRI combined with ADC between hepatic primary mucosa-associated lymphoid tissue lymphoma and hepatocellular carcinoma［J］.J Army Med Univ，2025，47（17）：2053-2060.DOI：10.16016/j.2097-0927.202504103. DOI：

摘要

目的

探究增强MRI影像特征联合表观弥散系数（apparent diffusion coefficient， ADC）在肝原发性黏膜相关淋巴组织（mucosa-associated lymphoid tissue，MALT）淋巴瘤与肝细胞癌（hepatocellular carcinoma， HCC）中的鉴别诊断价值。

方法

纳入1997年1月至2025年5月在陆军军医大学第一附属医院放射科经病理证实的10例肝原发性MALT淋巴瘤患者和20例HCC患者的临床资料，分析增强MRI图像，主要包括肿瘤数目、形态、信号特征、强化方式以及有无血管漂浮征，同时在ADC图测量ADC值，筛选有统计学意义的变量。采用Firth回归分析筛选肝原发性MALT淋巴瘤的独立预测因素。运用受试者工作特征（receiver operating characteristic，ROC）曲线下面积（area under the curve，AUC）评估诊断效能。

结果

肝原发性MALT淋巴瘤组与HCC组对比，女性发病率更高（

0.026），多数患者AFP

8 ng/mL（

0.001），T2WI信号较低（

0.001），ADC值更低（

0.001），病灶多呈持续强化（

0.001），更易出现血管漂浮征（

0.008）。单因素Firth回归分析显示，性别（95%

：1.36~52.10，

=0.020）、T2WI信号（95%

：3.89~5 121.00，

0.001）、AFP（95%

：0~0.21，

0.001）、ADC值（95%

：0~0.21，

0.001）、动态强化方式（95%

：0~0.23，

0.001）、血管漂浮征（95%

：0~0.40，

0.004）是诊断肝原发性MALT淋巴瘤的预测因素。多因素Firth回归分析显示，ADC值（95%

：0.00~0.62，

=0.006）、AFP（95%

：0~0.05，

=0.01）和动态强化方式（95%

：0~0.39，

=0.005）是诊断肝原发性MALT的独立预测因素。ADC值诊断肝原发性MALT淋巴瘤的AUC为0.96（敏感性为0.8，特异性为1.0）；AFP诊断肝原发性MALT淋巴瘤的AUC为0.85（敏感性为1.0，特异性为0.7）；动态强化方式诊断肝原发性MALT淋巴瘤的AUC为0.85（敏感性为0.8，特异性为0.9）。

结论

动态强化方式与ADC值可作为肝原发性MALT淋巴瘤与HCC的鉴别标志，为临床术前评估提供参考。

Abstract

Objective‍　‍To investigate the value of enhanced MRI image features combined with apparent diffusion coefficient(ADC) in the differential diagnosis of primary hepatic mucosa-associated lymphoid tissue(MALT) lymphoma and hepatocellular carcinoma(HCC). Methods‍　‍The clinical data of 10 patients with pathology-confirmed primary MALT lymphoma admitted in our hospital from January 1997 to May 2025 were retrospectively collected. Their enhanced MRI images were analyzed

mainly including the number of lesions

morphology

signal characteristics

enhancement methods

and presence or absence of vessel floating signs

and the ADC value was calculated in order to screen statistically significant variables. Firth regression analysis was used to screen independent predictors of primary MALT lymphoma in the liver. Receiver operating characteristic(ROC) curve was plotted

and the area under the curve(AUC) was calculated to evaluate the diagnostic efficacy. Results‍　‍Compared with the HCC group

the primary MALT lymphoma group had significantly higher incidence in the females(

=0.026)

alpha-fetoprotein(AFP)

8 ng/mL(

0.001)

lower T2WI signal(

=0.001)

lower ADC value(

0.001)

and mostly continuously enhanced lesions(

0.001)

and more vessel floating signs(

=0.008). Univariate Firth regression analysis showed that sex(95%

: 1.36~52.10

=0.020)

T2 value(95%

: 3.89~5 121.00

0.001)

AFP(95%

: 0~0.21

0.001)

ADC value(95%

: 0~0.21

0.001)

and dynamic reinforcement(95%

: 0~0.23

0.001)

and vessel floating sign(95%

: 0~0.40

=0.004) were diagnostic predictors for primary MALT lymphoma of the liver. Multivariate Firth

regression analysis indicated that ADC value(95%

: 0~0.62

=0.006)

AFP(95%

: 0~0.047

=0.01)

and dynamic reinforcement(95%

: 0~0.39

=0.005) were independent predictors for primary MALT in the liver. ROC curve analysis indicated that the AUC value of ADC value in diagnosing primary MALT lymphoma was 0.96

with a sensitivity of 0.8 and a specificity of 1.0

and the AUC value of AFP level in diagnosing primary MALT lymphoma was 0.85

with a sensitivity of 1.0 and a specificity of 0.7. The AUC value of dynamic reinforcement in diagnosing primary MALT lymphoma was 0.85

with a sensitivity of 0.8

and a specificity of 0.9. Conclusion‍　‍Dynamic reinforcement and ADC value can be used as differential markers for primary MALT lymphoma and HCC

providing reliable reference for clinical preoperative evaluation.

关键词

Keywords

references

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