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Objective Toinvestigatetheconsistencyofultrasoundand MSCTindiagnosing microvascularinvasion (MVI)in hepatocellularcarcinoma,andtocomparethediagnosticefficiencyofbothtwomethods.Methods TheultrasoundandMSCTdataof 82patientswithhepatocellularcarcinomawerecollected.Accordingtothepostoperativepathologicalresults,theconsistencyanddiagnostic efficiencyofultrasoundandMSCTindiagnosingMVIinhepatocellularcarcinomawerecompared.Results Accordingtothepostoperative pathologicalfindingsof82patients,30caseswerepositiveofMVI,while52caseswerenegative.ThepreoperativeMSCTandultrasound examinations had a strong consistency (Cohen’s Kappa＝0.829 ,P＜0.001 ).The sensitivity ,specificity and accuracy of preoperative ultrasoundinpredictingtheMVIinhepatocellularcarcinomawere76.67% (23/30),67.31% (35/52)and70.73% (58/82),respectively. Thesensitivity,specificityandaccuracyofpreoperativeMSCTinpredictinghepatocellularcarcinomaMVIwere83.33% (25/30),73.08%(38/52)and75.61% (63/82),respectively.Conclusion Preoperativeultrasoundand MSCThavegoodconsistencyandhighdiagnostic efficiencyindiagnosing MVIinhepatocellularcarcinoma.
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Liver cancer is one of the most common malignant tumors in the world, and at present, China has the highest incidence rate of liver cancer. Liver cancer has an insidious onset, and patients often have no obvious symptoms in the early stage; however, due to the rapid progression of this disease, most patients have developed advanced tumors at the time of diagnosis, and about 10% of patients have microvascular invasion (MVI) at initial pathological diagnosis. Although continuous improvement and progress have been made in the treatment methods for liver cancer, there is no significant reduction in postoperative recurrence rate. Many studies support that MVI is one of the independent risk factors for liver cancer recurrence, and patients with MVI determined by pathological diagnosis often have poor prognosis. However, there is still a lack of preoperative evaluation methods for MVI. This article analyzes and integrates the studies on MVI in the past 3 to 5 years, in order to provide a comprehensive understanding of the research advances in MVI.
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Microvascular invasion, as a predictive factor for postoperative recurrence of hepatocellular carcinoma (HCC), can only be diagnosed by the gold standard of pathological histology at present. Conventional imaging examination and serological markers have low sensitivity and specificity in evaluating microvascular invasion. Preoperative prediction and evaluation of microvascular invasion has an important value in selecting clinical treatment and assessing patient diagnosis. In recent years, magnetic resonance (MR) functional imaging and new contrast agents have been developing rapidly and have become the research hotspots in early diagnosis of HCC, postoperative follow-up of treatment outcome, and recurrence evaluation. This article elaborates on the significance of apparent diffusion coefficient of diffusion-weighted magnetic resonance imaging in evaluating microvascular invasion, as well as the potential value of intravoxel incoherent motion-magnetic resonance imaging and a new diffusion model of diffusion kurtosis imaging. This article also analyzes the application of dynamic contrast-enhanced magnetic resonance imaging and Gd-EOB-DTPA-specific MR in evaluating microvascular invasion and predicting postoperative recurrence. The analysis shows that the development of MR functional imaging and the application of several new techniques play an important role in the assessment of microvascular invasion of HCC and can determine the risk of postoperative recurrence and metastasis and provide reliable quantitative assessment indices for early diagnosis and reasonable application of surgery and other treatment methods.