Objective To investigate the value of plain and gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid(Gd-EOB-DTPA)enhanced MRI for differentiating clear cell hepatocellular carcinoma(CCHCC)and non-otherwise specified hepatocellular carcinoma(NOS-HCC).Methods Totally 36 CCHCC(CCHCC group)patients and 72 age-matched NOS-HCC(NOS-HCC group)patients were enrolled.Univariate analysis and multivariate logistic regression were used to retrospectively analyze the clinical,pathological and plain upper abdominal MRI as well as Gd-EOB-DTPA enhanced MRI data,so as to screen the independent predictors for distinguishing CCHCC and NOS-HCC.Receiver operating characteristic(ROC)curve was drawn,and the area under the curve(AUC)was calculated to evaluate the efficacy of MRI-related independent predictors for distinguishing CCHCC and NOS-HCC individually and in combination.Results Pathologic Edmondson-Steiner grade of HCC,lesions with fat components showed on MRI,the ratio of lesion-to-liver signal intensity on plain T1WI(LLRT1WI)and the ratio of lesion-to-muscle signal intensity on plain T1WI(LMRT1WI)were all independent predictors for distinguishing CCHCC from NOS-HCC(all P＜0.05).The AUC of lesions with fat components,LLRT1WI and LMRT1WI for distinguishing CCHCC and NOS-HCC alone was 0.652,0.689 and 0.687,respectively,and of the combination was 0.762,higher than that of lesions with fat components(Z=-2.401,P=0.016)but not different with AUC of LLRT1WI(Z=-1.841,P=0.066)and LMRT1WI(Z=-1.440,P=0.150)alone.Conclusion Plain and Gd-EOB-DTPA enhanced MRI could be used to distinguish CCHCC and NOS-HCC.