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The value of Gd-EOB-DTPA enhanced MRI in predicting microvascular invasion of hepatocellular carcinoma and its grade
WANG Jing  ZHENG Jin  SUN Jun  SHEN Li 

Cite this article as: Wang J, Zheng J, Sun J, et al. The value of Gd-EOB-DTPA enhanced MRI in predicting microvascular invasion of hepatocellular carcinoma and its grade[J]. Chin J Magn Reson Imaging, 2021, 12(12): 79-83, 88. DOI:10.12015/issn.1674-8034.2021.12.016.


[Abstract] Objective To evaluate the predictive value of Gd-EOB-DTP-enhanced MRI in the occurrence and grading of microvascular invasion of (MVI) in hepatocellular carcinoma (HCC). Materials and Methods: Sixty-seven patients with primary HCC confirmed by postoperative pathology were retrospectively studied. All cases were divided into MVI positive group and MVI negative group according to whether there was microvascular invasion or not. The general data and laboratory examination, Gd-EOB-DTPA enhanced MRI imaging data and postoperative tumor histopathological grading data were analyzed, and the independent risk factors affecting microvascular invasion in patients with hepatocellular carcinoma were obtained. ROC curve was drawn to evaluate the diagnostic efficacy of independent risk factors. Furthermore, according to the histological characteristics of microvascular invasion, all patients with hepatocellular carcinoma were divided into M0 group, M1 group and M2 group. The effect of P＜0.05 in univariate analysis on MVI grade was studied.Results Univariate analysis showed that there were significant differences in tumor margin、rim enhancement、peritumoral enhancement in arterial phase and peritumoral hypointensity in the hepatobiliary phase between MVI positive group and MVI negative group. Further multivariate Logistic regression analysis showed that peritumoral enhancement in the arterial phase and peritumoral hypointensity in the hepatobiliary phase were independent risk factors for the occurrence of MVI in hepatocellular carcinoma. The results of diagnostic effectiveness analysis of independent risk factors showed that the area under the curve (AUC) of peritumoral enhancement in the arterial phase and peritumoral hypointensity in the hepatobiliary phase were 0.669 and 0.636, respectively. The sensitivity and specificity of peritumoral enhancement in the arterial phase were 93.8% and 40.0%, respectively, and the sensitivity and specificity of peritumoral hypointensity in the hepatobiliary phase were 84.4% and 42.9%, respectively. Furthermore, all patients with hepatocellular carcinoma were divided into M0 group, M1 group and M2 group according to MVI grade. The results showed that there were significant differences in peritumor rim enhancement in arterial phase, low signal intensity in hepatobiliary phase and tumor margin among different MVI grades, and it can be seen from the data that the higher the MVI grade, the greater the proportion of peritumoral enhancement in the arterial phase and peritumoral hypointensity in the hepatobiliary phase.Conclusions In Gd-EOB-DTPA enhanced MRI, peritumoral enhancement in the arterial phase and peritumoral hypointensity in the hepatobiliary phase can be used as effective indexes to predict microvascular invasion of HCC before operation, while peritumoral enhancement in the arterial phase and peritumoral hypointensity in the hepatobiliary phase and tumor margin can be used to predict MVI grade of HCC.
[Keywords] primary hepatocellular carcinoma；microvascular invasion；gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid；magnetic resonance imaging；risk factors

WANG Jing   ZHENG Jin*   SUN Jun   SHEN Li  

Department of Radiology, Subei People's Hospital, the Clinical Medical College of Yangzhou University, Yangzhou 225001, China

Zheng J, E-mail: zhj65220@163.com

Conflicts of interest   None.

Received  2021-07-05
Accepted  2021-10-12
DOI: 10.12015/issn.1674-8034.2021.12.016
Cite this article as: Wang J, Zheng J, Sun J, et al. The value of Gd-EOB-DTPA enhanced MRI in predicting microvascular invasion of hepatocellular carcinoma and its grade[J]. Chin J Magn Reson Imaging, 2021, 12(12): 79-83, 88. DOI:10.12015/issn.1674-8034.2021.12.016.

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