The value of preoperative ultrasound in predicting microvascular invasion of hepatocellular carcinoma

Abstract

Objective To analyze the ultrasound imaging features and clinical characteristics in patients with hepatocellular carcinoma (HCC), and assess the value of ultrasound in preoperatively predicting microvascular invasion(MVI) of HCC. Methods One hundred and seventy-one patients with HCC were retrospectively collected from January 2016 to July 2018. The ultrasound imaging features and clinical data that may be associated with MVI were analyzed by univariate and multivariate analyses, and the diagnostic efficacy of independent risk factors was further evaluated. ROC curves were plotted to compare the diagnostic efficacy of combined diagnostic mode 1, mode 2, peritumoral enhancement, and tumor margin. Results Univariate analysis showed that the serum AFP level, tumor size, peritumoral hypoechoic halo, peritumoral enhancement, and tumor margin were significantly correlated with MVI (P<0.05). Multivariate logistic regression analysis further indicated that peritumoral enhancement and non-smooth tumor margin were the independent risk factors for predicting MVI. The sensitivity, specificity, positive predictive value and negative predictive value of peritumoral enhancement and non-smooth tumor margin were 51.4% vs 83.8%, 81.4% vs 48.5%, 67.9% vs 55.4%, and 68.7% vs 79.7%, respectively. The AUC of mode 1, mode 2, peritumoral enhancement and tumor margin were 0.741, 0.716, 0.664, and 0.661, respectively. Conclusions Preoperative ultrasound is valuable in predicting MVI of HCC. Peritumoral enhancement and non-smooth tumor margins are independent risk factors for predicting MVI of HCC. Tumor size, hypoechoic halo around the tumor, and serum AFP levels must be taken into account when predicting MVI of HCC by using preoperative ultrasound. Key words: Ultrasonography; Carcinoma, hepatocellular; Contrast-enhanced ultrasound; Microvascular invasion; Risk factors