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.

Objective To retrospective analysis the onset characteristics and outcome of surgical management in patients with giant cell tumor (GCT) of distal tibia,explore the operation indication and the risk factors for recurrence and limb function.Methods From October 2000 to June 2014,Fifteen patients with GCT in the distal tibia from domestic three bone tumor centers were involved in this study.They included 8 males and 7 females,with an average age of 35.9± 10.4 years.There were 11 cases of Campanacci Ⅱ and 4 cases of Campanacci Ⅲ.Two cases of Campanacci Ⅱ occurred pathologic fracture.Expanded curettage surgery was performed in 11 cases and tumor resection with revascularization was performed in 4 cases.Factors influencing the choice of surgery,recurrence and limb function were analyzed.These included tumor size,ankle condition,Campanacci grade,pathological fracture.Results A1l patients were followed up with a mean duration of 62.3±25.2 months,ranging from 26 to 60 months.One of 11 patients treated with extended curettage underwent local recurrence.One of 4 patients treated with marginal excision underwent local recurrence.The effect of Campanacci classification and pathological fracture on selection of operation scheme was analyzed.The effects of pathological fractures,Campanacci classification,surgical methods and postoperative functional score (MSTS score) on postoperative recurrence rate were analyzed.Single factor analysis showed that the pathological fractures did not affect the selection of GCT surgical treatment plan (P=1.000).Campanacci classification affected the selection of GCT surgical treatment plan (P=0.001).Pathological fractures,Campanacci classification and surgical methods were not related to the local recurrence rate (P ＞ 0.05).Expanded curettage of Campanacci grade Ⅱ patients with better postoperative MSTS score than tumor segment resected Campanacci grade Ⅲ patients (t=3.385,P=0.005).There was no significant relationship between pathological fracture and postoperative MSTS score.Conclusion Distal tibia GCT Campanacci classification and whether combined with pathological fracture or not affects the choice of surgical procedure and postoperative functional recovery.