Abstract: Objective The aim of this study was to explore multimodal ultrasound in evaluating microvascular invasion (MVI) in patients with primary liver cancer (PLC) receiving transarterial chemoembolization (TACE). Methods 63 patients with hepatocellular carcinoma (HCC) were encountered in our hospital between January 2022 and January 2024, and all of them received TACE and followed-up for 12 months. All patients underwent multimodal ultrasound examination before surgery for intratumorous blood flow signal evaluation. Multivariate Logistic regression analysis was performed to identify the factors hinting MVI existence. Results Liver histo-pathological examination found MVI in 27 cases(42.9%) out of our 63 patients with HCC; the proportions of patients with tumors ≥ 5 cm, incomplete tumor capsule, unsmoothed tumor edges, tumor blood flow signal score, type III blood flow signal, peritumoral enhancement, equal and low enhancement at portal vein phase and at delayed phase in the MVI group were 63.0%, 66.7%, 63.0%, (1.9±0.5), 70.4%, 48.2%, 92.6% and 96.3%, all significantly greater than 36.1%, 38.9%, 36.1%, (1.4±0.3), 42.7%, 19.4%, 69.4% and 77.8% (P＜0.05) in those without MVI, while the clearance time was (60.8±15.5)s, significantly shorter than [(82.7±21.6)s, P＜0.05] in those without MVI; multivariate Logistic regression analysis showed that blood flow signal, enhancement at delayed phase and clearance time were the independent factors indicating MVI occurrence(P＜0.05); by end of 12-month follow-up, the deteriorated tumors was 70.4% in MVI group, much higher than 25.0%(P＜0.05) in tumors without MVI. Conclusion Multimodal ultrasound is helpful in evaluating MVI before TACE operation, which might guide make decisions for appropriate TACE plan.

Key words: Hepatoma, Microvascular invasion, Transarterial chemoembolization, Multimodal ultrasound, Therapy