Preoperative risk prediction and prognostic study of the isolated macrotrabecular-massive hepatocellular carcinoma using Gd-EOB-DTPA enhanced MRI
10.3969/j.issn.1002-1671.2024.12.011
- VernacularTitle:基于钆塞酸二钠增强MRI对孤立性粗梁-团块型肝细胞癌的术前风险预测及预后研究
- Author:
Zuyi YAN
1
,
2
;
Zixin LIU
;
Xueqin ZHANG
;
Tao ZHANG
;
Chunyan GU
;
Mengtian LU
;
Jifeng JIANG
Author Information
1. 南通大学,江苏 南通 226006
2. 南通大学附属南通第三医院 南通市第三人民医院影像科,江苏 南通 226006
- Keywords:
hepatocellular carcinoma;
macrotrabecular-massive hepatocellular carcinoma;
magnetic resonance imaging
- From:
Journal of Practical Radiology
2024;40(12):1984-1988
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the value of the liver imaging reporting and data system v2018(LI-RADS v2018)and other imaging features in predicting preoperative risk and postoperative prognosis of isolated macrotrabecular-massive hepatocellular carcinoma(MTM-HCC).Methods Patients with isolated hepatocellular carcinoma(HCC)confirmed by pathology after preoperative MRI examination were selected,and all patients were randomly assigned to a training group(n=146)and a validation group(n=62)in a 7∶3 ratio.Least absolute shrinkage and selection operator(LASSO)regression and multivariate logistic regression were used to screen independent prognostic factors of MTM-HCC and construct a nomogram.Patients were stratified into high-risk and low-risk subgroups based on the nomogram scores.Kaplan-Meier survival curves and Log-rank tests were used to compare the recurrence-free survival(RFS)among different subgroups of patients.Results Multivariate logistic regression analysis revealed that intratumoral vessels[odds ratio(OR)=3.480,95％confidence interval(CI)1.110-10.912,P=0.032],arterial phase hypovascular component ≥20％(OR=4.615,95％CI 1.728-12.321,P=0.002),and corona enhancement(OR=4.814,95％CI 1.816-12.766,P=0.002)were independent predictors of MTM-HCC.The nomogram constructed based on these indicators demonstrated area under the curve(AUC)of the receiver operating characteristic(ROC)curve was 0.834 and 0.764 for predicting MTM-HCC in the training and validation groups,respectively.The RFS predicted by the nomogram was significantly different between the high-risk and low-risk subgroups and both the pathologically confirmed MTM-HCC positive and negative groups(P＜0.05).Conclusion Intratumoral vessels,arterial phase hypovascular component ≥20％,and corona enhancement are independent predictors of MTM-HCC.The constructed nomogram based on these predictors demonstrates good diagnostic efficacy for MTM-HCC and has significant prognostic value for patients'RFS.
