Abstract: Objective The aim of this study was to investigate the diagnostic performance of CT and magnetic resonance imaging (MRI) scan in combination with serum alpha-fetoprotein (AFP) and protein induced by vitamin K absence or antagonist-II (PIVKA-II) PIVKA-II levels in patients with hepatitis B-induced liver cirrhosis (LC) with space-occupying lesions(SOL). Methods A total of 108 patients with hepatitis B-induced LC were encountered in our hospital between January 2022 and January 2025, and all had intrahepatic SOL as showed by CT and/or MRI. Serum AFP and PIVKA-II levels were routinely assayed. The diagnosis was proven by histo-pathological examination based on fine needle aspiration or post-operational specimen. Receiver operating characteristic (ROC) curves was applied to evaluate the diagnostic efficacy. Results Of the108 patients with LC, histo-pathological examination diagnosed hepatocellular carcinoma (HCC) in 70 cases(64.8%) and focal nodular hyperplasia (FNH) in 38 cases (35.2%); serum AFP and PIVKA-II levels in patients with HCC were(321. 3±50.8)ng/mL and (458.6±136.5)mAU/mL, both significantly higher than [(8.2±1.1)ng/mL and (48.6±5.1)mAU/mL, respectively, P<0.05]in those with FNH; in our series, CT found malignant lesions in 64 cases and MRI diagnosed in 69 cases; the AUC was 0.976 (95%CI:0.926-0.996), with sensitivity of 100.0%, specificity of 94.7% and accuracy of 100.0%, when CT and MRI in combination with serum AFP and/or PIVKA-II levels in diagnosing HCC. Conclusion Multi-phase CT and MRI dynamic contrast-enhanced scan in combination with serum special tumor markers in differentiating intrahepatic SOL has a satisfactory efficacy in patients with hepatitis B-induced LC, which warrants multiple center investigation.

Key words: Hepatoma, Liver cirrhosis, CT dynamic contrast-enhanced scan, MRI, Alpha-fetoprotein, Protein induced by vitamin K absence or antagonist-II, Diagnosis