Value of low-dose multi-slice spiral CT combined with multiparametric magnetic resonance imaging in differential diag-nosis of small hepatocellular carcinoma and regenerative nodules in cirrhosis

JI Xiaoran; SUN Yi; CHEN Yingxin

doi:10.20258/j.cnki.1006-9011.2025.07.0017

Abstract：Objective To explore the value of low-dose multi-slice computed tomography(MDCT)combined with multipara-metric magnetic resonance imaging(MRI)in the differential diagnosis of small hepatocellular carcinoma(SHCC)and regenerat-ing nodules in liver cirrhosis.Methods The medical records of 128 patients with SHCC and regenerative nodules of cirrhosis,who were admitted to the hospital,were selected.Using pathological diagnosis as the gold standard,they were divided into SHCC group(42 cases)and cirrhosis group(86 cases)based on the nature of the nodules.All subjects underwent low-dose MDCT and multiparametric MRI examinations to compare the CT values of liver parenchyma enhancement in each stage and mul-tiparametric MRI quantitative parameters,in terms of average enhancement time,enhancement rate,maximum slope of in-crease,maximum slope of decrease,and apparent diffusion coefficient(ADC),between the two groups.ROC curves were drawn to evaluate the diagnostic value of low-dose MDCT and multiparametric MRI for SHCC and regenerative nodules in liver cirrho-sis.Results The enhanced CT values of liver parenchyma in the SHCC group during the delayed and portal venous phases were lower than those in the cirrhosis group(P<0.05),and the enhanced CT values of liver parenchyma in the arterial phase were higher than those in the cirrhosis group(P<0.05).The average enhancement time,enhancement rate,maximum increase slope,and ADC of the SHCC group were lower than those of the SHCC group,while,the maximum decrease slope was higher than that of the cirrhosis group(P<0.05).The positive predictive values of low-dose MDCT,multi parameter MRI,and combined diagno-sis of SHCC were 72.00%(36/50),77.55%(38/49),and 75.00%(42/56),while,the negative predictive values were 92.31%(72/78),94.94%(75/79),and 100%(72/72).The accuracy rates were 84.38%(108/128),88.28%(113/128),and 89.06%(114/128),with consistency Kappa values of 0.662,0.745,and 0.771.ROC analysis showed that the sensitivity of low-dose MDCT and multi parameter MRI in diagnosing SHCC were 85.71%,90.48%,and 100%,respectively.The speci-ficity was 83.72%,87.21%,and 83.72%,respectively.The area under the curve was 0.847,0.886,and 0.919,respectively.Conclusion Multi parameter MRI combined with low-dose MDCT can be used to assist in the diagnosis of SHCC and regenera-tive nodules in cirrhosis,with high diagnostic efficacy.