Diagnosing fibrous capsule formation of hepatocellular carcinoma by three-dimensional magnetic resonance elastography

Abstract

Objective To investigate the value of magnetic resonance elastography (MRE) in diagnosing the fibrous capsule (FC) formation of hepatocellular carcinoma (HCC). Methods Clinical data of 50 patients with HCC first diagnosed in the Third Affiliated Hospital of Sun Yat-sen University from December 2014 to October 2017 were retrospectively analyzed. Among them, 41 patients were male and 9 female, aged (49±10) years on average. The informed consents of all patients were obtained and the local ethical committee approval was received. The HCC scirrhosity was determined by MRE and the FC was diagnosed by dynamic contrast-enhanced MRI (DCE-MRI). Pathological examination was taken as the gold standard of diagnosis. All the patients were divided into FC group (n=28) and non-FC group (n=22). The diagnostic accuracy of MRE for FC was evaluated. The HCC scirrhosity were statistically compared between two groups by t test. The diagnostic efficiency of MRE and DCE-MRI for FC was assessed by receiver operating characteristic (ROC) curve and diagnostic test. Results In FC group, the HCC scirrhosity measured by MRE was (4.6±1.1) kPa, significantly lower than (6.7±2.8) kPa in non-FC group (t=-2.853, P<0.05). The area under ROC curve of MRE in diagnosing FC was 0.737, the optimal diagnostic threshold was5.6 kPa, the sensitivity, specificity and diagnostic accuracy were 0.89, 0.68 and 0.74, respectively. The sensitivity, specificity and diagnostic accuracy of DCE-MRI in diagnosing FC were 0.93, 0.09 and 0.56, respectively. Conclusions The HCC scirrhosity measured by MRE can accurately diagnose the formation of FC. The diagnostic efficiency of MRE is better than that of DCE-MRI. Key words: Carcinoma, hepatocellular; Fibrous capsule; Scirrhosity; Magnetic resonance elastography; Diagnosis