Department of Radiology, Zhongshan Hospital, Fudan University, and Shanghai Medical Imaging Institute, Shanghai, China.
Department of Pathology, Zhongshan hospital, Fudan University, Shanghai, China.
Eur J Radiol. 2019 Apr;113:7-14. doi: 10.1016/j.ejrad.2019.01.036. Epub 2019 Jan 31.
To retrospectively evaluate the value of MR features based on Liver Imaging Reporting and Data System (LI-RADS ver.2017) for identifying the status of cytokeratin (CK) 19 expression of HCC before surgery.
A total of 201 patients with 207 HCCs who underwent MR imaging were reviewed retrospectively. MR features based on LI-RADS ver.2017 as well as clinical data were compared between CK19-positive (n = 51) and CK19-negative (n = 156) HCCs groups. Potential predictive parameters were identified by univariate and multivariate logistic regression analysis and diagnostic odds ratios (ORs) were recorded.
MR features including targetoid appearance (p = 0.001) was more frequently observed while non-peripheral "washout" (p < 0.0001) and non-rim arterial phase hyper-enhancement (p < 0.0001) were found less frequently in CK19-positive HCCs compared to CK19-negative HCCs. At multivariate analysis, serum alphafetoprotein (AFP)>20 ng/ml (OR = 5.9) and targetoid appearance (OR = 4.2) and non-peripheral "washout" (OR = 0.2) were significant independent predictors of CK19-positive HCCs.
Targetoid appearance and absence non-peripheral "washout" combined with elevated AFP were useful for differentiating CK19-positive HCCs from CK19-negative HCC.
回顾性评估基于肝脏成像报告和数据系统（LI-RADS ver.2017）的 MR 特征在术前识别 HCC 细胞角蛋白（CK）19 表达状态的价值。
回顾性分析了 201 例 207 个 HCC 患者的 MR 图像，比较了 CK19 阳性（n=51）和 CK19 阴性（n=156）HCC 组的基于 LI-RADS ver.2017 的 MR 特征和临床资料。采用单因素和多因素逻辑回归分析确定潜在的预测参数，并记录诊断优势比（OR）。
与 CK19 阴性 HCC 相比，MR 特征包括靶样外观（p=0.001）更常见，而非外周“洗脱”（p<0.0001）和非边缘动脉期高增强（p<0.0001）较少见。多因素分析显示，血清甲胎蛋白（AFP）>20ng/ml（OR=5.9）、靶样外观（OR=4.2）和非外周“洗脱”（OR=0.2）是 CK19 阳性 HCC 的独立预测因素。
靶样外观和非外周“洗脱”的缺失结合 AFP 升高有助于区分 CK19 阳性 HCC 和 CK19 阴性 HCC。
