Non-hypervascular hypointense nodules detected by Gd-EOB-MPA-enhanced MRI are a risk factor for recurrence of HCC after hepatectomy
Non-hypervascular hypointense nodules detected by Gd-EOB-MPA-enhanced MRI are a risk factor for recurrence of HCC after hepatectomy
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DOI：
10.1016/j.jhep.2013.01.030
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发表时间：
2013-06-01
影响因子：
25.7
通讯作者：
Maeda, Atsuyuki
中科院分区：
文献类型：
--
作者：
Toyoda, Hidenori;Kumada, Takashi;Maeda, Atsuyuki
背景与目的：钆-乙氧基苄基-二乙烯-三胺五乙酸 (Gd-EOB-DTPA) 增强磁共振成像 (MRI) 通常显示肝细胞癌 (HCC) 患者肝胆期非富血管性低信号肝结节。目前尚不清楚这些结节的存在是否与肝切除术后 HCC 复发相关。我们进行了一项前瞻性观察性研究，探讨 Gd-EOB-DTPA 增强 MRI 肝胆相中非富血管性低信号肝结节的存在对肝切除术后 HCC 复发的影响。方法：对 77 例因原发性、非复发性、富血管性 HCC 接受肝切除术的患者进行前瞻性随访。 肝切除术。根据术前 Gd-EOB-DTPA 增强 MRI 上是否存在非富血管性低信号结节来比较术后复发率。结果：存在非富血管性低信号结节（风险比 1.9396 [1.3615-2.7222]）和存在非富血管性低信号结节的患者肝切除术后的复发率较高。 低信号结节是与术后复发（风险比 2.1767 [1.5089-3.1105]）以及 HCC 分化和门静脉侵犯相关的独立因素。虽然根据术前是否存在非富血管性低信号肝结节，肝内转移复发率没有差异，但术前存在非富血管性低信号肝结节的患者的多中心复发率显着较高。结论：术前检测到非富血管性低信号肝结节的患者 Gd-EOB-DTPA增强MRI肝胆期肝切除术后HCC复发风险较高，主要是多中心复发。 (C) 2013 年欧洲肝脏研究协会。由 Elsevier B.V. 出版。保留所有权利。
Background & Aims: The gadolinium-ethoxybenzyl-diethylene-triamine pentaacetic acid (Gd-EOB-DTPA)-enhanced magnetic resonance imaging (MRI) often depicts non-hypervascular hypointense hepatic nodules during the hepatobiliary phase in patients with hepatocellular carcinoma (HCC). It is unclear whether the presence of these nodules is associated with HCC recurrence after hepatectomy. We conducted a prospective observational study to investigate the impact of the presence of non-hypervascular hypointense hepatic nodules on the hepatobiliary phase of Gd-EOB-DTPA-enhanced MRI on the recurrence of HCC after hepatectomy.Methods: A total of 77 patients who underwent hepatectomy for primary, non-recurrent, hypervascular HCC were prospectively followed up after hepatectomy. Post-operative recurrence rates were compared according to the presence of non-hypervascular hypointense nodules on preoperative Gd-EOB-DTPA-enhanced MRI.Results: Recurrence rates after hepatectomy were higher in patients with non-hypervascular hypointense nodules (risk ratio 1.9396 [1.3615-2.7222]) and the presence of non-hypervascular hypointense nodules was an independent factor associated with postoperative recurrence (risk ratio 2.1767 [1.5089-3.1105]) along with HCC differentiation and portal vein invasion. While no differences were found in the rate of intrahepatic metastasis recurrence based on the preoperative presence of non-hypervascular hypointense hepatic nodules, the rate of multicentric recurrence was significantly higher in patients with preoperative nonhypervascular hypointense hepatic nodules.Conclusions: Patients with preoperative non-hypervascular hypointense hepatic nodules detected during the hepatobiliary phase of Gd-EOB-DTPA-enhanced MRI are at higher risk of HCC recurrence after hepatectomy, mainly due to multicentric recurrence. (C) 2013 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.