Abstract: Objective The aim of this study was to explore the diagnostic performance of multimodal magnetic resonance imaging (MRI) in differentiating dysplastic nodules (DN) and small hepatocellular carcinoma (sHCC) in patients with liver cirrhosis (LC). Methods 71 patients with LC with intrahepatic nodules were encountered in our hospital between December 2016 and December 2021, and all underwent multimodal MRI, with the dynamic enhancement (DCE-MRI) parameters, the apparent diffusion coefficient (ADC), pure diffusion coefficient (D) and pseudo diffusion coefficient (D*) recorded. The golden diagnosis was based on fine needle aspiration or post-operational histopathological examination. Results Among the 71 patients, the sHCC was diagnosed in 45 cases (63.4%), and the DN was found in 26 cases (36.6%); the ADC, D and D * in sHCC foci were (0.81±0.19)×10^-3mm² / s, (0.91±0.21)×10^-3mm² / s and (46.26±10.13)×10^-3mm² / s, significantly lower than [(1.34±0.33)×10^-3mm² / s, (1.22±0.24)×10^-3mm² / s and (80.69±13.24)×10^-3mm²/s, respectively, P＜0.05 ] in DN lesions; the ROC analysis showed that when the cut-off values of D, D * and ADC in diagnosing sHCC were set as 1.14×10^-3mm² / s, 62.40×10^-3mm² / s and 0.96×10^-3mm²/s, the AUC were 0.911 (95% CI: 0.820-0.966), 0.809 (95% CI: 0.699-0.893) and 0.984 (95% CI: 0.920-0.999). Conclusion The multimodal MRI has high diagnostic efficacy in differentiating DN and sHCC in patients with LC, which might provide evidence for appropriate management for the patients.

Key words: Hepatoma, Dysplastic nodule, Multimodal magnetic resonance imaging, Differential diagnosis