目的研究扩散加权成像ADC值与 肝细胞癌病理学特征及微血管侵犯的相关 性。方法 收集我院2015年2月至2018年2 月共133例肝细胞癌患者的病历资料，所 有患者均在我院接受MRI检查，测得扩散 加权成像ADC值。收集所有患者的病理学 资料，包括肝功能分级、肿瘤位置、肿 瘤直径、分化程度及有无微血管侵犯。 分析ADC值与肝细胞癌病理学特征及微血 管侵犯的相关性，绘制ADC值诊断低分化 肝细胞癌及微血管侵犯的ROC曲线。结 果 ADC值与肝细胞癌分化程度呈正相关 (P＜0.05)，与微血管侵犯呈负相关(P ＜0.05)。当ADC值≤1.097×10-3mm2 /s， 其诊断低分化肝细胞癌的灵敏度、特异 度、阳性预测值、阴性预测值、总符合率 分别为74.4%、77.7%、58.0%、88.0%、 76.7%。当ADC值≤1.138×10-3mm2 /s时， 其预测肝细胞癌微血管侵犯的灵敏度、特 异度、阳性预测值、阴性预测值、总符合 率分别为69.4%、67.0%、43.9%、85.5%、 67.7%。结论 扩散加权成像ADC值与肝细 胞癌分化程度呈正相关，与微血管侵犯呈 负相关，通过术前ADC值的测量可为肝细 胞癌治疗提供参考。

Objective To study the correlation between ADC values of diffusion-weighted imaging (DWI) and the pathological features and microvascular invasion of hepatocellular carcinoma. Methods A total of 133 patients with hepatocellular carcinoma who admitted to the hospital during the period from February 2015 to February 2018 were collected. All patients were examined by MRI and ADC values of DWI were measured. Pathological data of all patients were collected, including liver function, location of the lesion, diameter, differentiation degree and microvascular invasion of tumors. The correlation of ADC values with the pathological features and microvascular invasion of hepatocellular carcinoma were analyzed. The ROC curves for the diagnosis of poorly differentiated hepatocellular carcinoma and microvascular invasion with ADC values were plotted. Results The ADC value was positively correlated with the differentiation degree of hepatocellular carcinoma (P<0.05), and negatively correlated with microvascular invasion (P<0.05). When the ADC value was or lower than 1.097×10-3mm2 /s, the sensitivity, specificity, positive predictive value, negative predictive value and total coincidence rate for the diagnosis of poorly differentiated hepatocellular carcinoma were 74.4%, 77.7%, 58.0%, 88.0% and 76.7%, respectively. When the ADC value was or lower than 1.138×10-3mm2 / s, the sensitivity, specificity, positive predictive value, negative predictive value and total coincidence rate for predicting microvascular invasion of hepatocellular carcinoma were 69.4%, 67.0%, 43.9%, 85.5% and 67.7%, respectively. Conclusion The ADC values of DWI are positively correlated with the differentiation degree of hepatocellular carcinoma and negatively correlated with microvascular invasion. The measurement of preoperative ADC value can provide references for the treatment of hepatocellular carcinoma.