广西医科大学学报2023，Vol.40Issue(12)：2043-2050,8.DOI:10.16190/j.cnki.45-1211/r.2023.12.017
MRI增强扫描对原发性肝癌患者肝动脉化疗栓塞术后MVI预后的预测价值
The value of enhanced MRI scanning in predicting the prognosis of MVI after transcatheter arterial chemoembolization in patients with primary hepatocellular carcinoma
摘要
Abstract
Objective:To explore the prognostic value of enhanced magnetic resonance imaging(MRI)scanning in predicting the prognosis of microvascular invasion(MVI)after transcatheter arterial chemoembolization(TACE)in patients with primary hepatocellular carcinoma(PHC).Methods:A total of 100 PHC patients with MVI after TACE admitted to Nanchong Central Hospital of Sichuan Province from January 2020 to January 2022 were selected,and quantitative parameters[hepatic artery perfusion index(HPI),volume transfer constant(Ktrans)]were obtained by MRI enhanced scanning.The incidence of recurrence within 1 year after surgery was analyzed.The patients were divided into recurrence group and non-recurrence group according to whether recurrence oc-curred within 1 year after surgery.Clinical data,serum tumor markers[carcinoembryonic antigen(CEA),alpha-fetoprotein(AFP)],MRI imaging characteristics and quantitative parameters of the two groups were compared,and prognostic factors were analyzed by logistic regression model.The receiver operating characteristic(ROC)curve was used to analyze the value of MRI quantita-tive parameters in predicting recurrence,and the area under the ROC curve(AUC),net reclassification in-dex(NRI)as well as comprehensive discriminant im-provement index(IDI)were used to evaluate the prediction effect of prediction schemes with and without MRI quantitative parameters.Results:The recurrence rate of 98 patients was 45.92%(45/98)after 1 year follow-up.There were significant differences in tumor number,intratumoral necrosis,tumor diameter ratio,serum CEA and AFP levels between the recurrence group and the non-recurrence group(P＜0.05).MRI imaging features of pa-tients with and without recurrence were similar,but HPI and Ktrans in the recurrence group were higher than those in the non-recurrence group(P＜0.05).Tumor number,intratumbral necrosis,tumor diameter ratio,serum CEA,AFP,HPI and Ktrans were all influencing factors for postoperative recurrence(P＜0.05).The AUC predicted by HPI and Ktrans was 0.862,which was higher than that predicted by HPI and Ktrans alone(P＜0.05).The AUC with and without MRI quantitative parameter prediction scheme(0.930 vs.0.815)was significantly different(P＜0.05).NRI and IDI analysis showed that the prediction effect of the prediction scheme with MRI quantitative pa-rameters was significantly improved compared with that without MRI quantitative parameters(P＜0.05).Conclu-sion:Postoperative recurrence of PHC patients with MVI after TACE surgery is affected by the tumor number,in-tratumbral necrosis,tumor diameter ratio,serum CEA,AFP,HPI,Ktrans and other factors.The prediction scheme including MRI quantitative parameters HPI and Ktrans has a high value in predicting postoperative recurrence.关键词
原发性肝癌/微血管侵犯/肝动脉化疗栓塞术/磁共振成像Key words
primary hepatocellular carcinoma/microvascular invasion/transcatheter arterial chemoemboliza-tion/magnetic resonance imaging分类
医药卫生引用本文复制引用
王兴林,郭志伟,黄建儒,敬杰,李海青..MRI增强扫描对原发性肝癌患者肝动脉化疗栓塞术后MVI预后的预测价值[J].广西医科大学学报,2023,40(12):2043-2050,8.基金项目
四川省医学科研青年创新课题资助项目(No.Q20043) （No.Q20043）
