原发性肝癌MRI检查图像特征分析及联合血清AFP、TK1、DKK1的诊断价值研究

摘要 目的：研究原发性肝癌（PHC）磁共振成像（MRI）检查图像特征及其联合血清甲胎蛋白（AFP）、胸苷激酶1（TK1）、Dickkopf相关蛋白1（DKK1）的诊断价值。方法：将我院从2017年1月～2020年1月收治的PHC患者76例纳入研究，记作观察组。另取同期我院收治的70例良性肝病患者记作对照组。对所有受试者均进行MRI扫描，比较两组MRI图像特征。检测并对比两组血清AFP、TK1、DKK1水平的差异。通过受试者工作特征（ROC）曲线分析MRI及上述各项血清学指标诊断PHC的效能。结果：PHC患者T1WI主要表现为均匀低或稍低信号，T2WI主要表现为不均匀高信号，DWI均表现为均匀高信号。观察组血清AFP、TK1、DKK1水平均高于对照组（均P＜0.05）。经ROC曲线分析可得：MRI检查联合血清AFP、TK1、DKK1诊断PHC的曲线下面积、灵敏度、特异度、准确度均高于上述各项检查方式单独诊断。结论：PHC患者MRI图像特征如下：T1WI主要表现为均匀低或稍低信号，T2WI主要表现为不均匀高信号，DWI均表现为均匀高信号。此外，MRI检查联合血清AFP、TK1、DKK1诊断PHC的效能较高，具有一定的临床应用价值。

MRI Image Characteristics Analysis of Primary Hepatocellular Carcinoma and Its Diagnostic Value in Combination with Serum AFP, TK1 and DKK1

ABSTRACT Objective: To study the imaging characteristics of primary liver cancer (PHC) by magnetic resonance imaging (MRI) and its diagnostic value in combination with serum alpha-fetoprotein (AFP), thymidine kinase 1 (TK1) and Dickkopf-associated protein 1 (DKK1). Methods: 76 PHC patients who were admitted to the hospital from January 2017 to January 2020 were included in the study, which were recorded as the observation group. Another 70 patients with benign liver disease who were admitted to the hospital during the same period were taken as the control group. MRI scans were performed on all subjects, and the characteristics of MRI images between the two groups were compared. The difference of serum AFP, TK1 and DKK1 levels were detected and compared between the two groups. The efficacy of MRI and the above serological indicators in the diagnosis of PHC was analyzed by receiver operating characteristic (ROC) curve. Results: In PHC patients, T1WI was mainly manifested as homogeneous low or slightly low signal, T2WI was mainly manifested as heterogeneous high signal, and DWI was all manifested as homogeneous high signal. Serum AFP, TK1 and DKK1 levels in the observation group were all higher than those in the control group (all P<0.05). ROC curve analysis showed that the area under the curve, sensitivity, specificity and accuracy of MRI combined with serum AFP, TK1 and DKK1 levels in the diagnosis of PHC were all higher than above methods alone. Conclusion: MRI image characteristics of PHC patients are as follows: T1WI mainly showed homogeneous low or slightly low signal, T2WI mainly showed heterogeneous high signal, DWI showed homogeneous high signal. In addition, MRI examination combined with serum AFP, TK1 and DKK1 in the diagnosis of PHC is highly effective, and which has a certain clinical application value.