Relationship Between Signal Heterogeneity On Hepatobiliary Phase Of Gd-EOB-DTPA-enhanced Mri And Prognosis Of Hepatocelluar Carcinoma

Objective:To clarify relationship between signal heterogeneity on hepatobiliary phase of gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid(Gd-EOB-DTPA)-enhanced MRI and prognosis of hepatocellular carcinoma.Methods:From January 2014 to January 2017 in the First Affiliated Hospital of Chongqing Medical University,A total of 77 patients with the pathologically proved HCC underwent Gd-EOB-DTPA-enhanced MRI imaging prior to surgery and were included in the study.On the basis of the signal heterogeneity in the hepatobiliary phase,the lesions were divided into homogeneous hypointensity and heterogeneous hyperintensity.Disease-free survival time and influencing factors of disease-free survival time were compared between two groups.'Results:This study included 77 patients with hepatocellular carcinoma,including 45 cases of homogeneous hypointensity and 32 cases of heterogeneous hyperintensity.There were no significant differences in age,sex,etiology,liver function,alpha-fetoprotein,histological grade,child pugh,lesion diameter,lesion border and number of lesions between the 2 groups(P>0.05).However,HCC with heterogeneous hyperintensity had later barcelona(BCLC)staging(P =0.001).The average disease-free survival time for homogeneous hypointensity and heterogeneous hyperintensity were 17.0±9.8 months and 12.4± 10.4 months.The Kaplan-Meier survival curve showed that disease-free survival time was significantly higher in the homogeneous hypointensity group than in the heterogeneous hyperintensity group(P = 0.020).Univariate analysis showed that other confounding factors had no effect on the disease-free survival time of patients with hepatocellular carcinoma except for the signal of hepatobiliary phase(P>0.05).Furthermore,the hepatobiliary phase signal(P=0.047),BCLC stage(P=0.615)and degree of differentiation(P=0.449),which may be clinically considered as potentially influencing the prognosis of hepatocellular carcinoma patients,were included in the Cox multivariate proportional hazard regression model and found that the heterogeneous hyperintensity was still the risk factors of disease-free survival rate in hepatocellular carcinoma patients(P= 0.047).Conclusion:Signal heterogeneity on hepatobiliary phase of Gd-EOB-DTPA-enhanced MRI was related to the prognosis of HCC.Heterogeneous hyperintensity may indicate the lower disease-free survival rate.