Page 102 - 南京医科大学学报自然科学版

南京医科大学学报（自然科学版） 第42卷第1期
· 96 · Journal of Nanjing Medical University（Natural Sciences） 2022年1月

·影像研究·

不同MRI对比剂在预测肝细胞癌微血管侵犯中的应用探究

徐 迅，孙书文，刘秋萍，刘希胜 *
南京医科大学第一附属医院放射科，江苏 南京 210029

［摘 要］ 目的：基于 MRI 影像学特征探究肝脏特异性对比剂（Gd⁃EOB⁃DTPA）与常规对比剂（Gd⁃DTPA）在预测肝细胞癌
（hepatocellular carcinoma，HCC）微血管侵犯（microvascular invasion，MVI）上的差异。方法方法：：回顾性分析2010年1月—2019年1
月行手术治疗的 HCC 患者 253 例（Gd⁃DTPA 组 121 例、Gd⁃EOB⁃DTPA 组 132 例）。评估患者术前 MRI 影像学特征，通过多因
素 Logistic回归分别建立MVI预测模型，以受试者工作特征曲线及临床决策曲线评估模型效能及差异，并对患者术后生存情况
进行随访分析。结果：Gd⁃DTPA组中病灶大小、边界侵袭征及Gd⁃EOB⁃DTPA组中病灶大小、边界侵袭征、卫星灶是预测MVI的
独立风险因素。Gd⁃DTPA 组和Gd⁃EOB⁃DTPA 组模型的曲线下面积（area under curve，AUC）分别为0.761、0.791。临床决策曲
线显示 Gd⁃DTPA 与 Gd⁃EOB⁃DTPA 在预测 MVI 发生上具有相近的临床效益。生存分析显示组织病理证实的 MVI 阳性组与
MVI阴性组的平均无疾病生存时间及模型预测的MVI阳性组与MVI阴性组的平均无疾病生存时间均存在显著差异。结论：病
灶大小、病灶边界侵袭征及卫星灶是预测MVI的独立危险因素。使用Gd⁃EOB⁃DTPA在预测MVI发生方面不能比Gd⁃DTPA获
得更多临床效益，但是Gd⁃EOB⁃DTPA具有较高的敏感度。
［关键词］ 磁共振成像；肝脏特异性对比剂；微血管侵犯；肝细胞肝癌
［中图分类号］ R730.4 ［文献标志码］ A ［文章编号］ 1007⁃4368（2022）01⁃096⁃07
doi：10.7655/NYDXBNS20220118

Exploring the application of different MRI contrast agents in predicting microvascular
invasion of hepatocellular carcinoma

*
XU Xun，SUN Shuwen，LIU Qiuping，LIU Xisheng
Department of Radiology，the First Affiliated Hospital of Nanjing Medical University，Nanjing 210029，China

［Abstract］ Objective：This study aims to explore the difference between hepatic⁃specific contrast agent（Gd⁃EOB⁃DTPA）and
conventional contrast agent（Gd⁃DTPA）in predicting microvascular invasion（MVI）of hepatocellular carcinoma（HCC）based on MR
imaging features. Methods：A retrospective analysis of 253 patients with HCC who underwent surgical treatment from January 2010 to
January 2019（121 cases in Gd⁃DTPA group and 132 cases in Gd⁃EOB⁃DTPA group）were carried out. The preoperative MR imaging
features were evaluated，and MVI ⁃ prediction models were established through multi ⁃ factor logistic regression. Effectiveness and
differences of the models were assessed with receiver operating characteristic curves and clinical decision curves. A postoperative
survival analysis was also conducted. Results：Lesion size，border invasion in both Gd⁃DTPA and Gd⁃EOB⁃DTPA group，and satellite
lesions in Gd⁃EOB⁃DTPA group，are independent risk factors for predicting MVI. The area under the curve（AUC）of two models were
AUCGD⁃DTPA：0.761 and AUCGD⁃EOB⁃DTPA：0.791，respectively. The clinical decision curve shows that Gd⁃DTPA and Gd⁃EOB⁃DTPA have
similar clinical benefits in predicting MVI. Survival analysis illustrated that there were significant difference on the average disease⁃
free survival time between the MVI⁃positive group and the MVI⁃negative group not only confirmed by histopathology but also predicted
by the models. Conclusion：Lesion size，border invasion and satellite lesions are independent risk factors for predicting MVI. The
application of Gd⁃EOB⁃DTPA could not obtain more clinical benefits than Gd⁃DTPA in predicting MVI，but Gd⁃EOB⁃DTPA has a
higher sensitivity.
［Key words］ MR imaging；hepatic⁃specific contrast agent；microvascular invasion；hepatocellular carcinoma
［J Nanjing Med Univ，2022，42（01）：096⁃102］

［基金项目］ 国家自然科学基金（82071919）
∗
通信作者（Corresponding author），E⁃mail：liuxisheng2013@163.com