Department of Radiology, Zhongshan Hospital, Fudan University, No. 180 Fenglin Road, Xuhui District, Shanghai, 200032, China.
Department of Radiology, The Affiliated Suzhou Hospital of Nanjing University Medical School, No. 1 Lijiang Road, Suzhou, 215153, Jiangsu, China.
Abdom Radiol (NY). 2024 Aug;49(8):2629-2638. doi: 10.1007/s00261-024-04338-0. Epub 2024 Jun 5.
To explore which preoperative clinical data and conventional magnetic resonance imaging (MRI) features may indicate the presence of hepatocellular carcinoma (HCC) in HCC patients coexisting with LR-3 and LR-4 lesions.
HCC Patients coexisting with LR-3 and LR-4 lesions who participated in a prospective clinical trial (XX) were included in this study. Two radiologists independently assessed the preoperative MRI features and each lesion was assigned according to the liver imaging reporting and data system (LI-RADS). The preoperative clinical data were also evaluated. The relative values of these parameters were assessed as potential predictors of HCC for coexisting LR-3 and LR-4 lesions.
We enrolled 102 HCC patients (58.1 ± 11.5 years; 84.3% males) coexisting with 110 LR-3 and LR-4 lesions (HCCs group [n = 66]; non-HCCs group [n = 44]). The presence of restricted diffusion (OR: 18.590, p < 0.001), delayed enhancement (OR: 0.113, p < 0.001), and mild-moderate T2 hyperintensity (OR: 3.084, p = 0.048) were found to be independent predictors of HCC diagnosis. The sensitivity and specificity of the above independent variables for the diagnosis of HCC ranged from 66.7 to 80.3% and 56.8 to 88.6%, respectively. ROC analysis showed that, in discriminating HCC, the AUCs of the above factors were 0.777, 0.686, and 0.670, respectively. Combining these three findings for the prediction of HCC resulted in a specificity greater than 97%, and the AUC further increased to 0.874.
The presence of restricted diffusion, delayed enhancement, and mild-moderate T2 hyperintensity can be useful features for risk stratification of coexisting LR-3 and LR-4 lesions in HCC patients. Trial registration a prospective clinical trial (ChiCTR2000036201).
探讨哪些术前临床数据和常规磁共振成像（MRI）特征可提示共存 LR-3 和 LR-4 病变的 HCC 患者存在 HCC。
本研究纳入了参与前瞻性临床试验（XX）的共存 LR-3 和 LR-4 病变的 HCC 患者。两名放射科医生独立评估术前 MRI 特征，根据肝脏成像报告和数据系统（LI-RADS）对每个病变进行赋值。还评估了术前临床数据。评估这些参数的相对值作为共存 LR-3 和 LR-4 病变 HCC 的潜在预测指标。
我们纳入了 102 例共存 110 个 LR-3 和 LR-4 病变的 HCC 患者（58.1±11.5 岁；84.3%为男性）（HCC 组[n=66]；非 HCC 组[n=44]）。存在弥散受限（OR：18.590，p<0.001）、延迟强化（OR：0.113，p<0.001）和轻度中度 T2 高信号（OR：3.084，p=0.048）被认为是 HCC 诊断的独立预测因素。上述独立变量诊断 HCC 的敏感性和特异性分别为 66.7%至 80.3%和 56.8%至 88.6%。ROC 分析显示，在区分 HCC 时，上述因素的 AUC 分别为 0.777、0.686 和 0.670。将这三个因素结合起来预测 HCC 可使特异性大于 97%，AUC 进一步增加至 0.874。
弥散受限、延迟强化和轻度中度 T2 高信号的存在可能是 HCC 患者共存 LR-3 和 LR-4 病变风险分层的有用特征。
一项前瞻性临床试验（ChiCTR2000036201）。
