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