肝脏 ›› 2026, Vol. 31 ›› Issue (7): 984-988.

• 肝肿瘤 • 上一篇    下一篇

MRI纹理参数对肝细胞癌TACE术后早期复发的预测价值

刘伟, 王杰, 陈治西, 刘贤国   

  1. 611731 成都 三六三医院放射科(刘伟,王杰,陈治西),肿瘤科(刘贤国)
  • 收稿日期:2025-09-30 出版日期:2026-07-31 发布日期:2026-08-21
  • 通讯作者: 刘贤国,Email:doclxg@163.com
  • 基金资助:
    四川省医学(青年创新)科研课题(Q20074)

Predictive value of MRI texture parameters in hepatocellular carcinoma for early recurrence after TACE treatment

Liu Wei1, Wang Jie1, Chen Zhixi1, Liu Xianguo2   

  1. 1. Department of Radiology,Hospital 363, Chengdu 611731, China;
    2. Department of Oncology, Hospital 363, Chengdu 611731, China
  • Received:2025-09-30 Online:2026-07-31 Published:2026-08-21
  • Contact: Liu Xianguo,Email:doclxg@163.com

摘要: 目的 分析磁共振(MRI)纹理参数对肝细胞癌(HCC)患者经肝动脉化疗栓塞术(TACE)治疗后早期复发的预测价值。方法 采用回顾性分析法收集三六三医院142例HCC患者的临床资料(2019—2023年入院),均采用TACE治疗,根据治疗后早期是否复发分为两组(复发组和未复发组),对比其MRI纹理参数及其他临床资料,分析MRI纹理参数对TACE治疗后早期复发的预测效能。结果 142例HCC患者复发率为51.41%(73/142)。复发组动脉期的偏度[(0.45±0.12)比(0.25±0.05)]、熵[(5.45±0.56)比(4.87±0.40)]及AFP>400 ng/mL(58.90%比36.23%)、ALT>40 IU/L(34.25%比17.39%)、白蛋白≤35 g/L(65.75%比40.58%)比例高于未复发组,复发组静脉期的熵[(4.90±0.50)比(5.20±0.65)]低于未复发组(P<0.05)。Logistic回归分析模型显示,除ALT外,上述指标指标均为影响TACE后早期复发的因素,其中静脉期熵升高是保护因素(动脉期偏度和熵、AFP>400 ng/mL、白蛋白≤35 g/L、静脉期熵OR分别为1.994、1.363、1.782、1.887、0.869,P均<0.05)。ROC曲线分析结果显示,MRI纹理参数动脉期偏度、动脉期熵、静脉期熵联合预测HCC患者TACE后早期复发的曲线下面积(AUC)为0.852,高于单独检测(P<0.05)。结论 MRI纹理参数中,动脉期的偏度、熵值升高及静脉期熵值降低是TACE治疗后早期复发的因素,且具有早期复发的预测价值。

关键词: 肝细胞癌, 磁共振成像纹理参数, 经肝动脉化疗栓塞术, 复发

Abstract: Objective To analyze the value of magnetic resonance imaging (MRI) texture parameters in predicting the early recurrence of hepatocellular carcinoma (HCC) after TACE. Methods Retrospective analysis was used to collect the clinical data of 142 HCC patients (admitted to Hospital 363 from 2019 to 2023), all of whom were treated with TACE. They were divided into two groups according to whether there was a relapse in the early stage after treatment (relapse group and the non-recurrence group). MRI texture parameters and other clinical data were compared between the two groups, and the efficacy of MRI texture parameters in predicting early recurrence after TACE treatment was analyzed. Results The recurrence rate of 142 HCC patients was 51.41% (73/142). The arterial phase deviation [(0.45±0.12) vs. (0.25±0.05)], entropy [(5.45±0.56) vs. (4.87±0.40)], alpha-fetoprotein (AFP) > 400 ng/mL (58.90% vs. 36.23%), alanine aminotransferase (ALT) > 40 IU/L (34.25% vs. 17.39%), and albumin ≤35 g/L (65.75% vs. 40.58%) were higher than those in the non-recurrence group, and the entropy in the venous recurrence group [(4.90±0.50) vs. (5.20±0.65)] was lower than that in the non-recurrence group (P<0.05). Logistic regression analysis showed that all the above factors except ALT influencd the early recurrence after TACE, and the increase of entropy in venous phase was the protective factor (arterial phase deviation and entropy, AFP>400 ng/mL, albumin ≤35 g/L, venous phase entropy OR=1.994, 1.363, 1.782, 1.887, 0.869, all P<0.05). ROC analysis showed that the area under the curve (AUC) of MRI texture parameters combined with arterial phase skewness, arterial phase entropy and venous phase entropy predicted early recurrence after TACE in HCC patients was 0.852, which was higher than that of single detection (P<0.05). Conclusion Increased arterial skewness and entropy, and decreased entropy in venous phase are factors reflecting early recurrence after TACE treatment, and have predictive value in early recurrence.

Key words: Hepatocellular carcinoma, Magnetic resonance imaging texture parameters, Transhepatic arterial chemoembolization, Recrudescence