实用肝脏病杂志 ›› 2026, Vol. 29 ›› Issue (3): 405-408.doi: 10.3969/j.issn.1672-5069.2026.03.022

• 肝癌 • 上一篇    下一篇

增强MRI联合血清AFP和PIVKA-II诊断肝细胞癌应用研究*

徐小虎, 王维, 马秋莲, 于蓉, 许亚春, 祁荣兴   

  1. 226600 江苏省南通市 海安市人民医院影像科(徐小虎,王维,马秋莲,于蓉,许亚春);南通大学第二附属医院核医学科(祁荣兴)
  • 收稿日期:2025-09-01 出版日期:2026-05-10 发布日期:2026-05-18
  • 通讯作者: 许亚春,E-mail:m13776994488@163.com
  • 作者简介:徐小虎,男,44岁,大学本科,副主任医师。E-mail:13813740626@163.com
  • 基金资助:
    *江苏省南通市卫生健康委员会科研项目(编号:MS2022100)

Application of MRI feature in combination with serum AFP and PIVKA-II levels in early diagnosis of patients with hepatocellular carcinoma

Xu Xiaohu, Wang Wei, Ma Qiulian, et al   

  1. Department of Radiology, Hai'an People's Hospital, Nantong 226600, Jiangsu Province, China
  • Received:2025-09-01 Online:2026-05-10 Published:2026-05-18

摘要: 目的 分析增强MRI联合血清甲胎蛋白(AFP)和异常凝血酶原(PIVKA-II)水平诊断肝细胞癌(HCC)的应用价值。方法 2020年1月~2025年3月我院诊治的HCC患者121例,均接受Gd-EOB-DTPA增强MRI扫描,采用荧光免疫分析法检测血清AFP和PIVKA-II水平。绘制受试者工作特性曲线(ROC)分析增强MRI特征联合血清AFP和PIVKA-II水平诊断HCC的效能。结果 HCC病灶动脉期强化、门脉期呈低信号、肝胆特异期呈低信号和DWI呈高信号占比分别为85.1%、73.6%、85.1%和79.3%;本组121例HCC组血清AFP水平为(665.5±150.6)ng/mL,血清PIVKA-II水平为(1374.8±46.7)mAU/mL;以血清AFP水平>400 ng/mL 和PIVKA-II水平>400 mAU/mL 为截断点,经ROC曲线分析显示,MR提示病灶动脉期强化、肝胆特异期呈低信号和DWI呈高信号联合血清AFP和PIVKA-II水平诊断HCC的AUC为0.987(95%CI:0.964~0.997),其灵敏度为97.5%,特异度为93.2%。结论 应用增强MRI扫描特征联合血清AFP和PIVKA-II水平诊断HCC的效能高,具有很大的临床应用价值。

关键词: 肝细胞癌, 磁共振成像, 增强扫描, 甲胎蛋白, 异常凝血酶原, 诊断

Abstract: Objective The aim of this study was to investigate the application of MRI feature in combination with serum alpha fetoprotein and protein induced by vitamin K antagonist-Ⅱ(PIVKA-II) levels in early diagnosis of patients with hepatocellular carcinoma (HCC). Methods A total of 121 patients with HCC were encountered in our hospital between January 2020 and March 2025, and all underwent Gd-EOB-DTPA-enhanced MRI scan. Serum AFP and PIVKA-II levels were detected routinely. ROC curve was plotted to analyze the diagnostic efficacy of Gd-EOB-DTPA-enhanced MRI feature in combination with serum AFP and PIVKA-II levels for HCC. Results The percentages of enhancement at arterial phase, hypointensity at portal phase, hypointensity at hepatobiliary-specific phase and hyperintensity on DWI in HCC lesions were 85.1%, 73.6%, 85.1% and 79.3% in our series; serum AFP level was (665.5±150.6)ng/mL and serum PIVKA-II level was (1374.8±46.7)mAU/mL; when serum AFP level >400 ng/mL and PIVKA-II level >400 mAU/mL were set as the cut-off-value, the ROC analysis showed that the AUC was 0.987(95%CI:0.964-0.997), with sensitivity of 97.5% and specificity of 93.2% in diagnosing HCC based on MRI feature, and serum AFP and PIVKA-II level combination. Conclusion Gd-EOB-DTPA-enhanced MRI in combination with serum AFP and PIVKA-II levels demonstrates a satisfactory diagnostic efficacy for HCC, which might provide useful basis for clinical diagnosis and management.

Key words: Hepatocellular carcinoma, Gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid, Magnetic resonance imaging, Alpha fetoprotein, Protein induced by vitamin K antagonist-Ⅱ, Diagnosis