Abstract: Objective The purpose of this study was to explore the qualitative evaluation of intrahepatic nodules in patients with liver cirrhosis. Methods A retrospective analysis was performed on 124 cirrhotics with liver imaging reporting and data system (LI-RADS) 3 intrahepatic nodules. All, but fourpatients were followed-up for 60-78 (mean 74) months, and the MRI was conducted regularly. The fine needle aspiration liver biopsies werecarried out when necessary. The multivariate Logistic analysis was performed to reveal the risk factors. Results At the end of follow-up, 4 patients lost, and the cancerous foci were found in 24 cases (20.0%); the percentages of alcohol-taking, cigarettes smoking, concomitant diabetes, hepatitis B viral infections and alcoholic hepatitis in patients with intrahepatic cancerous lesions were 91.7%, 87.5%, 75.0%, 100.0% and 41.7%, allsignificantly higher than 45.8%, 52.1%, 41.7%, 58.3% and 20.8% (P<0.05) in patients without cancerous lesions; the Cox analysis showed that the alcohol-taking(HR=2.264, 95%CI=1.597-3.210, P<0.001), diabetes (HR=1.294, 95%CI=1.107-1.513, P=0.001), hepatitis B (HR=1.795, 95%CI=1.329- 2.561, P<0.001) and alcoholic hepatitis (HR=0.658, 95%CI=0.552-0.784, P<0.001) were the independent risk factors for patients with LR-3 intrahepatic foci; the formula was established based on the Cox analysis results, e.g.,Y=0.817X₁+0.258X₂+0.585X₃-0.419X₄(X₁=alcohol-taking, X₂=diabetes, X₃=hepatitis B, X₄=alcoholic hepatitis), and the ROC analysis demonstrated that the AUC was 0.812(SE=0.064, 95%CI=0.687-0.936, P<0.001), with the sensitivity of 0.833 and the specificityof 0.673, for liver cirrhotics with intrahepatic LR-3 nodules. Conclusion It might be important to follow-up liver cirrhosis patients with intrahepatic LR-3 nodules, especially in those with risk factors for malignant transformation, which could find cancerous lesions as soon as possible.

Key words: Liver cirrhosis, Magnetic resonance imaging, Liver imaging reporting and data system, Intrahepatic nodules, Hepatocellular carcinoma, Risk factors, Prediction