Objective To investigate the predictive value of a nomogram based on clinical factors and gadoxetic acid disodium(Gd-EOB-DTPA)-enhanced MRI features for predicting positive of vessels encapsulating tumor clusters(VETC)and/or positive of microvascular invasion(MVI)in patients with hep-atocellular carcinoma(HCC)(VM-HCC).Methods Clinical data of 240 patients with HCC who under-went radical hepatectomy in Affiliated Nantong Hospital 3 of Nantong University from August 2014 to Decem-ber 2021 were retrospectively analyzed.There were 169 males and 71 females,aged(58.4±9.1)years old,ranging from 35 to 82 years old.According to the status of MVI and VETC detected by postoperative pathology:121 cases HCC patients with VETC and/or MVI positive,and 119 cases HCC patients with VETC and MVI negative.Clinical data such as gender,age,protein induced by vitamin K absence or antagonist-Ⅱ(PIVKA-Ⅱ),and alpha-fetoprotein(AFP)level were collected.Multivariate logistic regression analysis was used to determine the independent predictors related to VM-HCC,and a nomogram model was construc-ted.C-index and receiver operating characteristic(ROC)curves were used to evaluate the model's discrimi-nation,and calibration curves were used to evaluate the model's consistency.Results Multivariate logistic regression showed that patients with PIVKA-Ⅱ ≥40 mAU/ml(OR=3.686,95％CI:1.883-7.217,P＜0.001),arterial peritumoral enhancement(OR=2.513,95％CI:1.154-5.476,P=0.020),≥50％arterial phase hypovascular component(OR=3.042,95％CI:1.535-6.028,P=0.001),peritumoral hypointensity on hepatobiliary phase(OR=2.682,95％CI:1.250-5.754,P=0.011),and lower tumor to liver contrast ratio on hepatobiliary phase(OR=0.024,95％CI:0.004-0.133,P＜0.001)had a high risk of VM-HCC.The above five independent risk factors were integrated to construct a nomogram model,the C-index was 0.828,and area under the curve was 0.83(95％CI:0.77-0.87),and the calibration curve had a good consistency.Conclusion The nomogram model based on indicators of clinical and Gd-EOB-DTPA-enhanced MRI has an effective performance in predicting microvascular metastasis patterns in HCC patients.
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