Abstract
OBJECTIVE: This study aimed to explore the diagnostic value of Gd-EOB-DTPA enhanced MRI in hepatocellular carcinoma (HCC) with hyperintensity on hepatobiliary phase (HBP) under the background of cirrhosis. METHODS: A retrospective analysis was conducted on 130 patients diagnosed with cirrhosis and exhibiting hyperintense lesions on HBP in Gd-EOB-DTPA enhanced MRI from January 2015 to December 2022. Of these patients, 56 were diagnosed with hepatocellular carcinoma and 74 had benign cirrhotic nodules. The morphology, signal characteristics, diameter, and ADC value of each lesion were evaluated. Univariate analysis and multivariate logistic regression analysis were performed to determine the independent risk factors of hepatocellular carcinoma and construct a diagnostic model. The diagnostic performance of the model was evaluated using a receiver operating characteristic (ROC) curve. RESULTS: We established a diagnostic model by combining the independent risk factors of HCC with hyperintensity on HBP, with an area under the ROC curve of 0.953, sensitivity and specificity were 92.86%、86.49% respectively. Furthermore, a nomogram model for diagnosing hepatocellular carcinoma with HBP hyperintensity was developed and demonstrated good calibration, fitting well with the standard curve. CONCLUSION: In hepatocellular carcinoma with HBP hyperintensity, the presence of mild-moderate T2-weighted imaging hyperintensity, absence of rim arterial phase hyperenhancement, diffusion-weighted imaging hyperintensity, ADC value ≤ 1.103 × 10(− 3)mm(2)/s, and peritumoral hyperintensity on HBP in Gd-EOB-DTPA enhanced MRI can provide valuable diagnostic information.