MRI征象对LI-RADS 5分肝癌微血管浸润及术后早期复发的预测价值  

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

作　　者：肖远强 李梦思 邝思驰[1] 张林启 朱婕 王劲[1] Xiao Yuanqiang;Li Mengsi;Kuang Sichi;Zhang Linqi;Zhu Jie;Wang Jin(Department of Radiology,the Third Affiliated Hospital of Sun Yat-sen University,Guangzhou 510630,China)

机构地区：[1]中山大学附属第三医院放射科,广州510630

出　　处：《中华肝脏外科手术学电子杂志》2021年第3期285-289,共5页Chinese Journal of Hepatic Surgery(Electronic Edition)

基　　金：国家自然科学基金重大研究计划培育项目(91959118);中华国际医学会交流基金会SKY影像科研基金项目(Z-2014-07-1912-15)。

摘　　要：目的探讨MRI征象对肝脏影像报告和数据系统(LI-RADS)5分的单发肝细胞癌(肝癌)患者微血管浸润(MVI)及术后早期复发的预测价值。方法回顾性分析2014年3月至2018年10月中山大学附属第三医院收治的211例肝癌肝切除术患者临床资料。其中男158例,女53例;年龄31~78岁,中位年龄47岁。所有患者术前1个月内行3.0-T动态增强MRI检查,均为LIRADS 5分(LR-5)的单发肝癌。根据组织病理学检查结果评估MVI,术后通过临床及影像学随访明确肿瘤早期复发。采用Logistic回归分析与术后早期复发相关的临床和影像学独立预测因子。结果211例肝癌切除患者中,57例病理证实MVI,49例术后肿瘤早期复发。多因素Logistic回归分析显示,马赛克征是肝癌MVI的独立预测因素(OR=2.308,95%CI:1.166~4.569,P<0.05);晕征是肝切除术后肝癌早期复发的独立预测因素(OR=2.447,95%CI:1.213~4.939,P<0.05)。结论对于LR-5单发肝癌患者,动态MRI的马赛克征和晕征可预测肝癌MVI和肝切除术后早期复发。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 contrastenhanced 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.

关 键 词：癌 肝细胞 磁共振成像 微血管浸润 复发 预测 

分 类 号：R735.7[医药卫生—肿瘤]