钆塞酸增强 MRI 对小肝细胞癌微血管侵犯的价值：一项回顾性研究。

Value of gadoxetic acid-enhanced MRI for microvascular invasion of small hepatocellular carcinoma: a retrospective study.

机构信息

Department of Gastrointestinal Medical Oncology, Harbin Medical University Cancer Hospital, No.150 Haping Road, Nangang District, Harbin, 150081, Heilongjiang, People's Republic of China.

Department of Radiology, Harbin Medical University Cancer Hospital, No. 150 Haping Road, Nangang District, Harbin, 150001, Heilongjiang, People's Republic of China.

出版信息

BMC Med Imaging. 2021 Mar 5;21(1):40. doi: 10.1186/s12880-021-00572-w.

DOI:10.1186/s12880-021-00572-w

PMID:33673821

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7934549/

Abstract

BACKGROUND

The objective of this study was to analyze the accuracy of gadolinium-ethoxybenzyl-diethylenetriamine penta-acetic acid enhanced magnetic resonance imaging (Gd-EOB-DTPA-MRI) for predicting microvascular invasion (MVI) in patients with small hepatocellular carcinoma (sHCC) preoperatively.

METHODS

A total of 60 sHCC patients performed with preoperative Gd-EOB-DTPA-MRI in the Harbin Medical University Cancer Hospital from October 2018 to October 2019 were involved in the study. Univariate and multivariate analyses were performed by chi-square test and logistic regression analysis. The sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of Gd-EOB-DTPA-MRI were performed by receiver operating characteristic (ROC) curves.

RESULTS

Univariate analysis indicated that alanine aminotransferase (≥ 39.00U/L), poorly differentiated pathology, and imaging features including grim enhancement, capsule enhancement, arterial halo sign and hepatobiliary features (tumor highly uptake, halo sign, spicule sign and brush sign) were associated with the occurrence of MVI (p < 0.05). Multivariate analysis revealed that rim enhancement and hepatobiliary spicule sign were independent predictors of MVI (p < 0.05). The area under the ROC curve was 0.917 (95% confidence interval 0.838-0.996), and the sensitivity was 94.74%.

CONCLUSIONS

The morphologies of hepatobiliary phase imaging, especially the spicule sign, showed high accuracy in diagnosing MVI of sHCC. Rim enhancement played a significant role in diagnosing MVI of sHCC.

摘要

背景

本研究旨在分析钆塞酸二钠增强磁共振成像（Gd-EOB-DTPA-MRI）预测小肝细胞癌（sHCC）患者微血管侵犯（MVI）的准确性。

方法

回顾性分析 2018 年 10 月至 2019 年 10 月在哈尔滨医科大学附属肿瘤医院行 Gd-EOB-DTPA-MRI 术前检查的 60 例 sHCC 患者的临床病理资料。采用卡方检验和 logistic 回归分析进行单因素和多因素分析。采用受试者工作特征（ROC）曲线分析 Gd-EOB-DTPA-MRI 对 MVI 的诊断效能。

结果

单因素分析显示，丙氨酸氨基转移酶（≥39.00U/L）、分化程度差、影像学特征（包括环形强化、包膜强化、动脉晕征和肝胆期特征）与 MVI 发生有关（p<0.05）。多因素分析显示，边缘强化和肝胆期的刺状征是 MVI 的独立预测因素（p<0.05）。ROC 曲线下面积为 0.917（95%置信区间 0.838-0.996），灵敏度为 94.74%。