Predictive value of multi-parametric MRI for preoperative microvascular invasion in mass-forming intrahepatic cholangiocarcinoma

QIU Wei; WEN Ru; CHEN Jia-fei; GUAN Yu

doi:10.11659/jjssx.02E026101

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Predictive value of multi-parametric MRI for preoperative microvascular invasion in mass-forming intrahepatic cholangiocarcinoma

Clinical Research | 更新时间：2026-10-26

- Predictive value of multi-parametric MRI for preoperative microvascular invasion in mass-forming intrahepatic cholangiocarcinoma
- JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY Vol. 35, Issue 10, Pages: 890-895(2026)
- 作者机构：
  
  陆军军医大学第一附属医院放射科，重庆 400038
- 作者简介：
- 基金信息：
- DOI：10.11659/jjssx.02E026101
  CLC： R445.2
- Received：25 February 2026，
  
  Published：25 October 2026
- 稿件说明：
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邱巍,温茹,陈家飞等.多参数MRI对肿块型肝内胆管癌术前微血管侵犯的预测价值[J].局解手术学杂志,2026,35(10):890-895.

QIU Wei,WEN Ru,CHEN Jia-fei,et al.Predictive value of multi-parametric MRI for preoperative microvascular invasion in mass-forming intrahepatic cholangiocarcinoma[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2026,35(10):890-895.
邱巍,温茹,陈家飞等.多参数MRI对肿块型肝内胆管癌术前微血管侵犯的预测价值[J].局解手术学杂志,2026,35(10):890-895. DOI： 10.11659/jjssx.02E026101.

QIU Wei,WEN Ru,CHEN Jia-fei,et al.Predictive value of multi-parametric MRI for preoperative microvascular invasion in mass-forming intrahepatic cholangiocarcinoma[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2026,35(10):890-895. DOI： 10.11659/jjssx.02E026101.

摘要

目的

探究多参数MRI预测肿块型肝内胆管癌（IMCC）术前微血管侵犯（MVI）的临床价值。

方法

回顾性分析2023年7月至2025年2月在我院接受根治性肝切除术的78例IMCC患者的临床及影像学资料，根据术后病理结果分为MVI阳性组（

=21）和MVI阴性组（

=57）。比较2组患者临床资料、肿瘤MRI特征。采用单因素与多因素

Logistic

回归分析2组患者发生MVI的独立影响因素，采用受试者工作特征（ROC）曲线评估多参数MRI的预测效能。

结果

2组患者性别、年龄、慢性乙肝/肝硬化病史、肿瘤分级、甲胎蛋白（APF）、肝功能指标比较，差异无统计学意义（

0.05）；2组肿瘤标志物癌胚抗原（CEA）

5 ng/mL、糖类抗原19-9（CA19-9）

37 U/mL的患者比例比较，差异有统计学意义（

0.05）；2组患者肿瘤最大径、多灶性肿瘤比例、肿瘤边缘不规则比例、表观扩散系数（ADC）值及富血供型强化比例比较，差异有统计学意义（

0.05）。单因素分析显示，CEA

5 ng/mL、CA19-9

37 U/mL、肿瘤最大径

5 cm、多灶性肿瘤、肿瘤边缘不规则、富血供型强化、ADC值升高与MVI发生相关（

0.05）。多因素Logistic回归分析显示，多灶性肿瘤、肿瘤边缘不规则、ADC值升高是MVI的独立预测因素（

0.05）。ROC曲线显示，多灶性肿瘤、肿瘤边缘不规则、ADC值预测MVI的曲线下面积（AUC）分别为 0.784、0.808、0.825，ADC值的最佳截断值为1.47×10

-3

/s，三者联合预测的AUC为0.895（95%

：0.821～0.962）、敏感度为85.71%、特异度为82.46%，预测效能显著优于任意单一指标（

0.05）。

结论

多灶性肿瘤、肿瘤边缘不规则、ADC值

1.47×10

-3

/s是IMCC患者术前MVI的重要预测指标，临床可结合MRI此类特征提高MVI术前预测准确性，为手术方案制定及预后评估提供可靠依据。

Abstract

Objective

To investigate the clinical value of multi-parametric MRI in predicting preoperative microvascular invasion （MVI） in mass-forming intrahepatic cholangiocarcinoma （IMCC）.

Methods

The clinical and imaging data of 78 patients with IMCC who underwent radical hepatectomy at our hospital from July 2023 to February 2025 were retrospectively analyzed. According to postoperative pathological results，the patients were divided into the MVI-positive group （

=21） and the MVI-negative group （

=57）. Clinical data and tumor MRI features were compared between the two groups. Univariate and mu

ltivariate Logistic regression analyses were used to identify the independent influencing factors for MVI in the two groups. Receiver operating characteristic（ROC） curves were used to evaluate the predictive performance of multi-parametric MRI.

Results

There were no statistically significant differences between the two groups in terms of gender， age， history of chronic hepatitis B/cirrhosis， tumor grade， alpha‑fetoprotein （AFP）， or liver function indicators （

0.05）.There were statistically significant differences between the two groups in the proportions of patients with tumor markers carcinoembryonic antigen （CEA）

5 ng/mL and carbohydrate antigen 19‑9 （CA19‑9）

37 U/mL （

0.05）.There were statistically significant differences in maximum tumor diameter，proportion of multifocal tumors，proportion of irregular tumor margins，apparent diffusion coefficient （ADC） values，and proportion of hypervascular enhancement between the two groups （

0.05）. Univariate analysis showed that CEA

5 ng/mL，CA19-9

37 U/mL，maximum tumor diameter

5 cm，multifocal tumors，irregular tumor margins，hypervascular enhancement，and elevated ADC values were associated with the occurrence of MVI （

0.05）.Multivariate Logistic

regression analysis showed that multifocal tumors，irregular tumor margins，and elevated ADC values were the independent predictors of MVI （

0.05）. ROC curve analysis showed that the area under the curve（AUC

）

of multifocal tumors，irregular tumor margins，and ADC values for predicting MVI were 0.784，0.808，and 0.825，respectively.The optimal cutoff value of ADC was 1.47×10⁻³ mm²/s.The AUC of the combined prediction of the three indicators was 0.895 （95%

：0.821 to 0.962），with a sensitivity of 85.71% and a specificity of 82.46%，demonstrating significantly better predictive performance than any single indicator alone（

0.05）.

Conclusion

Multifocal tumors，irregular tumor margins，and ADC value

1.47×10

-3

/s are important predictors of preoperative MVI in patients with IMCC. Clinically， combining these MRI features can improve the accuracy of preoperative MVI prediction and provide a reliable basis for surgical planning and prognosis evaluation.

关键词

Keywords

references

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