Analysis of the predictive efficacy of MRI signs and DWI-ADC in microvascular invasion of hepatocellular carcinoma
Objective To explore the diagnostic efficacy of magnetic resonance imaging(MRI)in high-risk signs and diffusion-weighted imaging(DWI-ADC)in microvascular invasion(MVI)of hepatocellular carcinoma.Methods Retrospective analysis of the clinical data of 80 patients with hepatocellular carcinoma admitted to our hospital from January 2021 to January 2023 was performed.Based on postoperative pathological results,the patients were divided into MVI positive group(33 cases)and MVI negative group(47 cases).The preoperative clinical characteristics,MRI high-risk signs,and ADC values of two groups of patients were compared.The value of ADC values in the occurrence of MVI in hepatocellular carcinoma patients was analyzed through receiver operator characteristic curve(ROC)analysis.Use multivariate analysis and unconditional logistic stepwise regression to analyze independent risk factors for MVI occurrence in hepatocellular carcinoma patients.Consistency was analyzed by Kappa.Results There was no statistically significant difference in gender,age,liver cirrhosis,tumor diameter,tumor size,and tumor location between the two groups(P＞0.05).The proportion of poorly differentiated,continuous multiple nodules,incomplete capsule,and irregular enhancement around the tumor in the MVI positive group was higher than that in the MVI negative group,and the ADC value in the MVI positive group was lower than that in the MVI negative group(P＜0.05).After ROC analysis,it was confirmed that ADC values can be used to predict the occurrence of MVI in hepatocellular carcinoma patients.The area under the curve was 0.843,the sensitivity was 92％,and the specificity was 64％.Multivariate logistic stepwise regression analysis showed that low differentiation,continuous multinodular lesion morphology,incomplete capsule,irregular enhancement around the tumor,ADC value＜1.330 × 10-3mm2/s was a influencing factor for the occurrence of MVI in hepatocellular carcinoma patients(P＜0.05).After consistency analysis,it was confirmed that the sensitivity,specificity,positive predictive value,negative predictive value,and Kappa value of the combined detection of MRI signs and DWI-ADC for predicting MVI occurrence in hepatocellular carcinoma patients were 79％,94％,90％,86％,and 0.74,respectively.Conclusion When MRI shows poorly differentiated,continuous multinodular lesions,incomplete capsule,irregular enhancement around the tumor,and ADC value＜1.330×10-3mm2/s,patients with hepatocellular carcinoma have a higher risk of developing MVI,and MRI high-risk signs combined with ADC values have a higher diagnostic effect on MVI in hepatocellular carcinoma.
Liver neoplasmsDiffusion magnetic resonance imagingMicrovascularDiagnostic efficiency
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