摘要
目的分析钆塞酸二钠增强磁共振(Gd-EOB-MRI)检查中,肝脏影像学报告和数据系统(LI-RADS)的晕状强化(CoE)、强化包膜(EC)征象对于最大径≤3.0cm的肝细胞癌(HCC)的诊断价值。探讨CoE、EC征象与微血管侵犯(MVI)的关系及其对MVI的预测价值。方法回顾性分析2020年4月至2024年7月浙江大学医学院附属第一医院(n=102)和树兰(杭州)医院(n=48)接受Gd-EOB-MRI检查的150例HCC患者的病例资料。采用χ^(2)检验比较HCC与非HCC病灶、MVI阳性与阴性HCC病灶的影像学征象差异;并采用多元Logistic回归法分析CoE、EC、CoE+EC征象与MVI的关系,绘制受试者工作特征(ROC)曲线,分析其对MVI的预测价值。结果150例HCC患者共175个病灶,CoE、EC、CoE+EC征象在HCC病灶与非HCC病灶(31个)的差异具有统计学意义(P<0.05)。CoE、EC、CoE+EC征象均与MVI显著相关(P<0.001,P=0.009,P<0.001)。CoE、EC、CoE+EC征象预测MVI的AUC值分别为0.70、0.68、0.71。结论EC、CoE、CoE+EC征象可以提高Gd-EOB-MRI对最大径≤3.0 cm HCC的诊断价值。CoE、EC、CoE+EC征象可以预测HCC病灶是否存在MVI,且CoE联合EC征象预测MVI的效能优于单一征象的预测效能。
Objective To analyze the diagnostic value of the liver imaging reporting and data system(LIRADS)features——corona enhancement(CoE)and enhancing capsule(EC),in Gd-EOB-MRI examination for hepatocellular carcinoma(HCC)with a diameter≤3.0 cm.To explore the relationship between features of CoE,EC and microvascular invasion(MVI)and the corresponding predictive value for MVI.Methods A retrospective analysis was conducted on the medical records of 150 HCC patients,who underwent Gd-EOB-MRI at the First Affiliated Hospital of Zhejiang University(n=102)and Shulan(Hangzhou)Hospital(n=48)from Apr.2020 to Jul.2024.Chi-square test was used to compare the differences in imaging features between HCC and non-HCC lesions,as well as MVI-positive and MVI-negative lesions,to assess the diagnostic value of features CoE,EC,and CoE+EC for HCC.Multivariate Logistic regression analysis was performed to explore the relationship between CoE,EC,CoE+EC and MVI.Receiver operating characteristic(ROC)curves were plotted to evaluate the predictive value of CoE,EC,and CoE+EC for MVI.Results A total of 175 lesions were identified in 150 HCC patients.Statistically significant differences were found between HCC lesions and non-HCC lesions(n=31)in the terms of CoE,EC,and Co+EC(P<0.05).CoE,EC,and CoE+EC were significantly associated with MVI(P<0.001,P=0.009,P<0.001,respectively).The area under the ROC curve(AUC)of EC,CoE,and CoE+EC for predicting MVI were 0.68,0.70,and 0.71,respectively.Conclusion Imaging features CoE,EC,and CoE+EC all can enhance the diagnostic value of Gd-EOB-MRI for HCC with a diameter≤3.0 cm.The presence of CoE,EC,and CoE+EC can predict the existence of microvascular invasion(MVI)in HCC lesions,and the combination of CoE+EC has superior efficacy in predicting MVI.
作者
杨天
宋梦晨
叶圣利
曹国洪
陈峰
YANG Tian;SONG Mengchen;YE Shengli;CAO Guohong;CHEN Feng(Department of Radiology,Shulan(Hangzhou)Hospital,Hangzhou,Zhejiang 310000,China;Department of Radiology,the First Affiliated Hospital of Zhejiang University,Hangzhou,Zhejiang 310058,China)
出处
《肝胆胰外科杂志》
2025年第8期524-528,F0003,共6页
Journal of Hepatopancreatobiliary Surgery
基金
杭州市医药卫生科技项目(ZD20220053)。
