Chinese Hepatolgy ›› 2022, Vol. 27 ›› Issue (10): 1088-1091.

• Liver Cancer • Previous Articles     Next Articles

The value of preoperative ultrasonic microflow grading in predicting microvascular invasion of hepatocellular carcinoma

MA Guo-jie1, FANG Jing-jing2, YANG Xian-kui3, HE Xiao4   

  1. 1. Department of Ultrasonic Diagnosis General Hospital of Hebi Coal Industry Group Co. LTD (Hebi Second People' s Hospital), Henan 458030, China;
    2. Department of Computed Tomography, General Hospital of Hebi Coal Industry Group Co. LTD (Hebi Second People' s Hospital), Henan 458030, China;
    3. Department of Emergency Hebi People' s Hospital, Henan 458030, China;
    4. Department of Ultrasonic Diagnosis, the First Affiliated Hospital of Zhengzhou University, Henan 450000, China
  • Received:2022-02-07 Online:2022-10-31 Published:2022-11-22

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Abstract: Objective To investigate the value of preoperative ultrasonic microflow grading in predicting microvascular invasion (MVI) in patients with hepatocellular carcinoma (HCC). Methods A total of 138 HCC patients were admitted to our hospital between August 2018 and August 2021. They were divided into MVI group (60 cases) and MVI group (78 cases) according to the pathological results. Serum alpha-fetoprotein (AFP) level was detected by immunofluorescence method before surgery. At the same time, ultrasound microflow imaging and contrast imaging were performed to record the tumor size, microflow grade, microflow distribution, tumor edge morphology, peritumor enhancement and other imaging characteristics. The independent predictive factors of MVI were analyzed, and the predictive efficacy of serum AFP level combined with imaging characteristics of MVI was investigated. Results The proportion of serum AFP level ≥400 μg/L in MVI group was 28.3%, which was significantly higher than that of 12.8% in MVI group (P<0.05); The proportions of tumor size >5 cm, grade Ⅲ microflow grade, unsmooth tumor margin and peritumoral enhancement in MVI group were 58.3%, 40.0%, 83.3% and 51.7%, respectively, which were significantly higher than those of 34.6%, 20.5%, 51.3% and 17.9% in MVI group (P<0.05). Serum AFP level, tumor size, micro-blood flow grade, unsmooth tumor margin and peritumoral enhancement were independent predictors of MVI in HCC patients (P<0.05). The area under curve (AUC), sensitivity, specificity and accuracy of serum AFP level combined with imaging features (including tumor size, microflow grading, tumor margin unsmoothness and peritumoral enhancement) in predicting MVI were 0.954, 93.3%, 97.4% and 95.7%, respectively. Conclusion In addition to serum AFP level, unsmooth tumor margin, tumor size and peri-tumor strength, preoperative ultrasonic microflow grade was also an independent predictor of MVI in HCC patients. The prediction efficiency could be further improved by a combination of the above indicators.

Key words: Ultrasonic microflow imaging, Contrast-enhanced ultrasound, Microflow grading, Hepatocellular carcinoma, Microvascular invasion