目的:探讨哪些术前临床数据和常规磁共振成像(MRI)特征可能表明伴有LR-3和LR-4病变的HCC患者存在肝细胞癌(HCC)。
方法:本研究包括参与前瞻性临床试验(XX)的LR-3和LR-4病变共存的HCC患者。两名放射科医生独立评估术前MRI特征,并根据肝脏影像学报告和数据系统(LI-RADS)分配每个病变。还评估了术前临床数据。这些参数的相对值被评估为共存LR-3和LR-4病变的HCC的潜在预测因子。
结果:我们招募了102例HCC患者(58.1±11.5岁;84.3%男性),并伴有110个LR-3和LR-4病变(HCC组[n=66];非HCC组[n=44])。限制扩散的存在(OR:18.590,p<0.001),延迟增强(OR:0.113,p<0.001),发现轻度-中度T2高强度(OR:3.084,p=0.048)是HCC诊断的独立预测因子。上述自变量对HCC诊断的敏感性和特异性分别为66.7~80.3%和56.8~88.6%,分别。ROC分析表明,在区分HCC时,上述因素的AUC分别为0.777、0.686和0.670。结合这三个发现预测HCC的特异性大于97%,AUC进一步增加到0.874。
结论:存在限制扩散,延迟增强,和轻度-中度T2高强度可以是HCC患者中共存的LR-3和LR-4病变的风险分层的有用特征。试验注册前瞻性临床试验(ChiCTR2000036201)。
OBJECTIVE: To explore which preoperative clinical data and conventional magnetic resonance imaging (MRI) features may indicate the presence of hepatocellular carcinoma (HCC) in HCC patients coexisting with LR-3 and LR-4 lesions.
METHODS: HCC Patients coexisting with LR-3 and LR-4 lesions who participated in a prospective clinical trial (XX) were included in this study. Two radiologists independently assessed the preoperative MRI features and each lesion was assigned according to the liver imaging reporting and data system (LI-RADS). The preoperative clinical data were also evaluated. The relative values of these parameters were assessed as potential predictors of HCC for coexisting LR-3 and LR-4 lesions.
RESULTS: We enrolled 102 HCC patients (58.1 ± 11.5 years; 84.3% males) coexisting with 110 LR-3 and LR-4 lesions (HCCs group [n = 66]; non-HCCs group [n = 44]). The presence of restricted diffusion (OR: 18.590, p < 0.001), delayed enhancement (OR: 0.113, p < 0.001), and mild-moderate T2 hyperintensity (OR: 3.084, p = 0.048) were found to be independent predictors of HCC diagnosis. The sensitivity and specificity of the above independent variables for the diagnosis of HCC ranged from 66.7 to 80.3% and 56.8 to 88.6%, respectively. ROC analysis showed that, in discriminating HCC, the AUCs of the above factors were 0.777, 0.686, and 0.670, respectively. Combining these three findings for the prediction of HCC resulted in a specificity greater than 97%, and the AUC further increased to 0.874.
CONCLUSIONS: The presence of restricted diffusion, delayed enhancement, and mild-moderate T2 hyperintensity can be useful features for risk stratification of coexisting LR-3 and LR-4 lesions in HCC patients. Trial registration a prospective clinical trial (ChiCTR2000036201).