Predictive value of MRI signs for microvascular invasion and postoperative early recurrence in patients with LI-RADS 5 hepatocellular carcinoma

doi:10.3877/cma.j.issn.2095-3232.2021.03.011

Abstract

Abstract:

Objective

To evaluate the predictive value of MRI sings for the microvascular invasion (MVI) and postoperative early recurrence in patients with single hepatocellular carcinoma (HCC) classified as Liver Imaging Reporting and Data System (LI-RADS) 5.

Methods

Clinical data of 211 HCC patients undergoing hepatectomy in the Third Affiliated Hospital of Sun Yat-sen University from March 2014 to October 2018 were retrospectively analyzed. Among them, 158 patients were male and 53 female, aged from 31 to 78 years with a median age of 47 years. All patients received 3.0-T dynamic contrast-enhanced MRI examination within 1 month before operation, and all of them were diagnosed with single HCC classified as LI-RADS 5 (LR-5). MVI was evaluated according to the histopathological examination result. Early recurrence of HCC was confirmed by clinical and imaging follow-up. The independent clinical and imaging predictors for postoperative recurrence were analyzed by Logistic regression analysis.

Results

Among 211 patients undergoing hepatectomy, 57 cases were pathologically diagnosed with MVI and 49 cases developed postoperative early recurrence. Multivariate Logistic regression analysis revealed that mosaic sign was an independent predictor for MVI in HCC patients (OR=2.308, 95%CI: 1.166-4.569, P<0.05). Halo sign was an independent predictor for early recurrence of HCC after hepatectomy (OR=2.447, 95%CI:1.213-4.939, P<0.05).

Conclusion

Mosaic and halo signs of dynamic MRI can predict MVI and early recurrence after hepatectomy in patients with single HCC classified as LR-5.

Key words: Carcinoma, hepatocellular, Magnetic resonance imaging, Microvascular invasion, Recurrence, Forecasting

Yuanqiang Xiao, Mengsi Li, Sichi Kuang, Linqi Zhang, Jie Zhu, Jin Wang. Predictive value of MRI signs for microvascular invasion and postoperative early recurrence in patients with LI-RADS 5 hepatocellular carcinoma[J]. Chinese Journal of Hepatic Surgery(Electronic Edition), 2021, 10(03): 285-289.

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References 19

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因素	单因素分析			多因素分析
	OR	95%CI	P值	OR	95%CI	P值
AFP>400 μg/L	2.250	1.133～4.469	0.021	1.954	0.955～4.000	0.067
马赛克征	2.770	1.434～5.352	0.002	2.308	1.166～4.569	0.016
晕征	1.906	0.971～3.742	0.031	1.688	0.822～3.385	0.156
弥散受限	2.667	0.321～22.167	0.364
不规则肿瘤边缘	1.929	1.037～3.588	0.038	1.465	0.758～2.830	0.256

因素	单因素分析			多因素分析
	OR	95%CI	P值	OR	95%CI	P值
AFP>400 μg/L	2.250	1.133～4.469	0.021	1.954	0.955～4.000	0.067
马赛克征	2.770	1.434～5.352	0.002	2.308	1.166～4.569	0.016
晕征	1.906	0.971～3.742	0.031	1.688	0.822～3.385	0.156
弥散受限	2.667	0.321～22.167	0.364
不规则肿瘤边缘	1.929	1.037～3.588	0.038	1.465	0.758～2.830	0.256

因素	单因素分析			多因素分析
	OR	95%CI	P值	OR	95%CI	P值
AFP>400 μg/L	0.866	0.395～1.900	0.720
马赛克征	1.281	0.670～2.449	0.043	1.070	0.541～2.115	0.846
晕征	2.537	1.287～5.144	0.007	2.447	1.213～4.939	0.012
弥散受限	0.904	0.177～4.628	0.903
不规则肿瘤边缘	1.630	0.850～3.124	0.048	1.483	0.751～2.929	0.257

因素	单因素分析			多因素分析
	OR	95%CI	P值	OR	95%CI	P值
AFP>400 μg/L	0.866	0.395～1.900	0.720
马赛克征	1.281	0.670～2.449	0.043	1.070	0.541～2.115	0.846
晕征	2.537	1.287～5.144	0.007	2.447	1.213～4.939	0.012
弥散受限	0.904	0.177～4.628	0.903
不规则肿瘤边缘	1.630	0.850～3.124	0.048	1.483	0.751～2.929	0.257

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