Predicting microvascular invasion of hepatocellular carcinoma according to hepatobiliary stage peritumoral hypointensity during gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid enhanced MRI / 中国医学影像技术

ABSTRACT

Objective: To investigate the value of hepatobiliary stage peritumoral hypointensity during gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid (Gd-EOB-DTPA) enhanced MR scanning for predicting microvascular invasion (MVI) of hepatocellular carcinoma (HCC). Methods: Data of 102 patients with HCC confirmed by pathology who received Gd-EOB-DTPA enhanced MRI were retrospectively analyzed. The patients were divided into MVI positive group and MVI negative group according to pathological findings. Then the presence or absence of hepatobiliary stage peritumoral hypointensity on enhanced MRI were evaluated, the shapes of MVI were depicted, and the sizes of HCC lesions were measured on MRI. The rates of peritumoral hypointensity were compared between groups and between different sized tumors, and the difference of peritumoral hypointensity shapes were analyzed and compared between groups. The sensitivity, specificity, accuracy, positive predictive value (PPV) and negative predictive value (NPV) for peritumoral hypointensity in predicting MVI of HCC were calculated. Results: Among 102 patients, 31 were found with MVI (MVI positive group) while 71 were not (MVI negative group) with pathological examinations. MRI showed peritumoral hypointensity in 26 patients, with 0.72-8.96 cm HCC (the median size 2.83 cm). Among 102 patients, HCC ≤3 cm was detected in 57 cases, >3 cm in 45 cases. Peritumoral hypointensity was observed in 20 patients in MVI positive group and 6 patients in MVI negative group (χ2=35.71, P3 cm (χ2=23. 21, P3 cm was 73.91% (17/23), 77.27% (17/22), 75.56% (34/45), 77.27% (17/22) and 73.91% (17/23), respectively. Conclusion: Hepatobiliary stage peritumoral hypointensity during Gd-EOB-DTPA enhanced MRI had high specificity for predicting MVI of HCC, especially for patients with ≤3 cm HCC.