Yang Jiawen, Dong Xue, Wang Guanliang, Chen Jinyao, Zhang Binhao, Pan Wenting, Zhang Huangqi, Jin Shengze, Ji Wenbin
Department of Radiology, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, 150 Ximen St, Linhai, Taizhou, 317000, Zhejiang, China.
Department of Radiology, Taizhou Hospital, Zhejiang University, Taizhou, 318000, Zhejiang, China.
Abdom Radiol (NY). 2023 Feb;48(2):554-566. doi: 10.1007/s00261-022-03740-w. Epub 2022 Nov 16.
This study aimed to analyze imaging features based on preoperative dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) for the identification of vessels encapsulating tumor clusters (VETC)-microvascular invasion (MVI) in hepatocellular carcinoma (HCC), VM-HCC pattern.
Patients who underwent hepatectomy and preoperative DCE-MRI between January 2015 and March 2021 were retrospectively analyzed. Clinical and imaging features related to VM-HCC (VETC + /MVI-, VETC-/MVI +, VETC + /MVI +) and Non-VM-HCC (VETC-/MVI-) were determined by multivariable logistic regression analyses. Early and overall recurrence were determined using the Kaplan-Meier survival curve. Indicators of early and overall recurrence were identified using the Cox proportional hazard regression model.
In total, 221 patients (177 men, 44 women; median age, 60 years; interquartile range, 52-66 years) were evaluated. The multivariable logistic regression analyses revealed fetoprotein > 400 ng/mL (odds ratio [OR] = 2.17, 95% confidence interval [CI] 1.07, 4.41, p = 0.033), intratumor vascularity (OR 2.15, 95% CI 1.07, 4.31, p = 0.031), and enhancement pattern (OR 2.71, 95% CI 1.17, 6.03, p = 0.019) as independent predictors of VM-HCC. In Kaplan-Meier survival analysis, intratumor vascularity was associated with early and overall recurrence (p < 0.05).
Based on DCE-MRI, intratumor vascularity can be used to characterize VM-HCC and is of prognostic significance for recurrence in patients with HCC.
本研究旨在基于术前动态对比增强磁共振成像（DCE-MRI）分析成像特征，以识别肝细胞癌（HCC）中包绕肿瘤结节的血管（VETC）-微血管侵犯（MVI），即VM-HCC模式。
回顾性分析2015年1月至2021年3月期间接受肝切除术及术前DCE-MRI检查的患者。通过多变量逻辑回归分析确定与VM-HCC（VETC+/MVI-、VETC-/MVI+、VETC+/MVI+）和非VM-HCC（VETC-/MVI-）相关的临床和影像学特征。采用Kaplan-Meier生存曲线确定早期和总体复发情况。使用Cox比例风险回归模型确定早期和总体复发的指标。
共评估了221例患者（177例男性，44例女性；中位年龄60岁；四分位间距52-66岁）。多变量逻辑回归分析显示，甲胎蛋白>400 ng/mL（比值比[OR]=2.17，95%置信区间[CI]1.07,4.41，p=0.033）、瘤内血管（OR 2.15，95%CI 1.07,4.31，p=0.031）和强化模式（OR 2.71，95%CI 1.17,6.03，p=0.019）是VM-HCC的独立预测因素。在Kaplan-Meier生存分析中，瘤内血管与早期和总体复发相关（p<0.05）。
基于DCE-MRI，瘤内血管可用于表征VM-HCC，对HCC患者的复发具有预后意义。
