Potential predictor of MRI peritumoral features in prognosis for colorectal liver metastases after non-anatomical hepatectomy

Liu Liu; Zhou Yin; Li Qingshu; Xie Lianghua; Mao Yun

doi:10.13406/j.cnki.cyxb.003234

您当前的位置：

首页 >

文章列表页 >

Potential predictor of MRI peritumoral features in prognosis for colorectal liver metastases after non-anatomical hepatectomy

Clinical research | 更新时间：2025-10-21

- Potential predictor of MRI peritumoral features in prognosis for colorectal liver metastases after non-anatomical hepatectomy
- Journal of Chongqing Medical University Vol. 48, Issue 5, Pages: 548-553(2023)
- 作者机构：
  
  1.重庆医科大学附属第一医院放射科，重庆 400016
  2.重庆医科大学基础医学院病理教研室，重庆 400016
- 作者简介：
- 基金信息：
- DOI：10.13406/j.cnki.cyxb.003234
  CLC： R445
- Received：15 September 2022，
  
  Revised：2023-04-06，
  
  Accepted：17 April 2023，
  
  Published：28 May 2023
- 稿件说明：
移动端阅览
刘柳,周印,李庆姝,等.MRI瘤周特征在预测结直肠癌肝转移非解剖性肝切除术预后的价值[J].重庆医科大学学报,2023,48(5):548-553.

Liu Liu,Zhou Yin,Li Qingshu,et al.Potential predictor of MRI peritumoral features in prognosis for colorectal liver metastases after non-anatomical hepatectomy[J].Journal of Chongqing Medical University,2023,48(5):548-553.
刘柳,周印,李庆姝,等.MRI瘤周特征在预测结直肠癌肝转移非解剖性肝切除术预后的价值[J].重庆医科大学学报,2023,48(5):548-553. DOI： 10.13406/j.cnki.cyxb.003234.

Liu Liu,Zhou Yin,Li Qingshu,et al.Potential predictor of MRI peritumoral features in prognosis for colorectal liver metastases after non-anatomical hepatectomy[J].Journal of Chongqing Medical University,2023,48(5):548-553. DOI： 10.13406/j.cnki.cyxb.003234.

摘要

目的

研究结直肠肝转移（colorectal liver metastases，CRLM）瘤周影像特征在非解剖切除（non-anatomic resection，NAR）后CRLM患者中长期预后的价值。

方法

回顾性纳入术前行腹部钆塞酸二钠增强磁共振成像（magnetic resonance imaging，MRI）和NAR术后的CRLM患者。影像特征评估动脉期瘤周高强化、肝胆期（hepatobiliary phase，HBP）瘤周低摄取和瘤周胆管扩张。应用Kaplan-Meier法计算生存率，并采用Cox比例风险回归模型进行单因素和多因素分析以确定无肝内复发生存期（liver recurrence-free survival，LRFS）、无复发生存期（recurrence-free survival，RFS）和总生存期（overall survival，OS）的独立预测因素。

结果

本研究共纳入36例患者，58个CRLM病灶。存在和不存在动脉期瘤周高强化的患者3年LRFS和RFS率有统计学差

异（LRFS：14.3% vs. 43.9%，

=0.005；RFS：14.3% vs. 40.3%，

=0.006）。动脉期瘤周高强化与较差的LRFS（

=0.002，

=5.541，95%CI=1.853~15.975）和较差的RFS（

=0.002，

=5.392，95%CI=1.887~15.412）独立相关。胆管扩张和HBP瘤周低摄取均不为LRFS、RFS和OS的独立预测因素。

结论

动脉期瘤周高强化是接受NAR的CRLM患者LRFS和RFS预后因子。

Abstract

Objective

To evaluate the potential long-term prognostic impact of peritumoral imaging features in patients with colorectal liver metastases（CRLM） after non-anatomic resection（NAR）.

Methods

Thirty-six patients who had abdominal gadoxetic acid-enhanced magnetic resonance imaging（MRI） before CRLM surgery were included in this retrospective research. Peritumoral early enhancement，peritumoral hypointensity on hepatobiliary phase（HBP），and biliary dilatation to the CRLM at MRI were evaluated. Survival estimates were calculated using the Kaplan-Meier method，and multivariate analysis was conducted to identify independent predictors of liver recurrence-free survival（LRFS）， recurrence-free survival（RFS） and overall survival（OS）.

Results

Overall， 36 patients with 58 CRLM were evaluated. There was a significant difference in 3-year LRFS and RFS rates between patients with and without peritumoral early enhancement（LRFS：14.3% vs. 43.9%，

0.005； RFS：14.3% vs. 40.3%，

0.006）. Peritumoral early enhancement was associated with poor LRFS［

=0.002， hazard ratio（

）=5.541，95%CI=1.853-15.975］ and poor RFS（

=0.002，

=5.392，95%CI=1.887-15.412） in patients with CRLM after NAR. However， bile duct dilatation and peritumoral hypointensity on HBP were not independent predictors of LRFS， RFS and OS.

Conclusion

In patients with CRLM after NAR， peritumoral early enhancement was predictor of LRFS and RFS.

关键词

Keywords

references

Hess KR ， Varadhachary GR ， Taylor SH ， et al . Metastatic patterns in adenocarcinoma [J ] . Cancer ， 2006 ， 106 （ 7 ）： 1624 - 1633 .

Hackl C ， Neumann P ， Gerken M ， et al . Treatment of colorectal liver metastases in Germany：a ten-year population-based analysis of 5 772 cases of primary colorectal adenocarcinoma [J ] . BMC Cancer ， 2014 ， 14 ： 810 .

Hellman S ， Weichselbaum RR . Oligometastases [J ] . J Clin Oncol ， 1995 ， 13 （ 1 ）： 8 - 10 .

Weichselbaum RR ， Hellman S . Oligometastases revisited [J ] . Nat Rev Clin Oncol ， 2011 ， 8 （ 6 ）： 378 - 382 .

Poston GJ ， Adam R ， Alberts S ， et al . OncoSurge：a strategy for improving resectability with curative intent in metastatic colorectal cancer [J ] . J Clin Oncol ， 2005 ， 23 （ 28 ）： 7125 - 7134 .

Andreou A ， Gloor S ， Inglin J ， et al . Parenchymal-sparing hepatectomy for colorectal liver metastases reduces postoperative morbidity while maintaining equivalent oncologic outcomes compared to non-parenchymal-sparing resection [J ] . Surg Oncol ， 2021 ， 38 ： 101631 .

Joechle K ， Vreeland TJ ， Vega EA ， et al . Anatomic resection is not required for colorectal liver metastases with RAS mutation [J ] . J Gastrointest Surg ， 2020 ， 24 （ 5 ）： 1033 - 1039 .

Niekel MC ， Bipat S ， Stoker J . Diagnostic imaging of colorectal liver metastases with CT，MR imaging，FDG PET，and/or FDG PET/CT：a Meta-analysis of prospective studies including patients who have not previously undergone treatment [J ] . Radiology ， 2010 ， 257 （ 3 ）： 674 - 684 .

Nakai Y ， Gonoi W ， Kurokawa R ， et al . MRI findings of liver parenchyma peripheral to colorectal liver metastasis：a potential predictor of long-term prognosis [J ] . Radiology ， 2020 ， 297 （ 3 ）： 584 - 594 .

Jiang Z ， Li CX ， Zhao ZX ， et al . Abnormal liver function induced by space-occupying lesions is associated with unfavorable oncologic outcome in patients with colorectal cancer liver metastases [J ] . Biomed Res Int ， 2018 ， 2018 ： 9321270 .

王晓耘，马增辉，史佩东 . 解剖性肝段切除术关键技术和争议 [J ] . 中华肝脏外科手术学电子杂志， 2020 ， 9 （ 4 ）： 317 - 320 .

Wang XY ， Ma ZH ， Shi PD . Key techniques and disputes of anatomical segmental hepatectomy [J ] . Chin J Hepatic Surg Electron Ed ， 2020 ， 9 （ 4 ）： 317 - 320 .

Fonseca GM ， Herman P ， Faraj SF ， et al . Pathological factors and prognosis of resected liver metastases of colorectal carcinoma：implications and proposal for a pathological reporting protocol [J ] . Histopathology ， 2018 ， 72 （ 3 ）： 377 - 390 .

Margonis GA ， Buettner S ， Andreatos N ， et al . Anatomical resections improve disease-free survival in patients with KRAS-mutated colorectal liver metastases [J ] . Ann Surg ， 2017 ， 266 （ 4 ）： 641 - 649 .

Shindoh J ， Makuuchi M ， Matsuyama Y ， et al . Complete removal of the tumor-bearing portal territory decreases local tumor recurrence and improves disease-specific survival of patients with hepatocellular carcinoma [J ] . J Hepatol ， 2016 ， 64 （ 3 ）： 594 - 600 .

Terayama N ， Matsui O ， Ueda K ， et al . Peritumoral rim enhancement of liver metastasis：hemodynamics observed on single-level dynamic CT during hepatic arteriography and histopathologic correlation [J ] . J Comput Assist Tomogr ， 2002 ， 26 （ 6 ）： 975 - 980 .

Nishie A ， Yoshimitsu K ， Asayama Y ， et al . Radiologic detectability of minute portal venous invasion in hepatocellular carcinoma [J ] . Am J Roentgenol ， 2008 ， 190 （ 1 ）： 81 - 87 .

Zeng H ， Shi GZ ， Mai SY ， et al . Imaging and clinical features of colorectal liver metastases with macroscopic intrabiliary growth [J ] . Eur J Radiol ， 2021 ， 137 ： 109616 .

Latorre Fragua RA ， Manuel Vazquez A ， Rodrigues Figueira Y ， et al . Intrabiliary metastases in colorectal cancer：a systematic review [J ] . J Hepatobiliary Pancreat Sci ， 2019 ， 26 （ 7 ）： 270 - 280 .

Lee Y ， Kim SY ， Lee SS ， et al . Pitfalls in Gd-EOB-DTPA-enhanced liver magnetic resonance imaging with an emphasis on nontumorous lesions [J ] . Clin Liver Dis ， 2018 ， 12 （ 2 ）： 50 - 59 .

Views

下载量

CSCD

Alert me when the article has been cited

提交

Tools

Publicity Resources

The value of enteral immunonutrition in therapeutic hepatectomy for patients with primary liver cancer

Feasibility of an in vitro phantom in high-resolution magnetic resonance imaging of endovaginal coil

Effect of circulating plasma cell on the prognosis of patients with multiple myeloma

Neurovascular coupling in patients with depression：a study based on multimodal magnetic resonance imaging

Prognostic study of ¹⁸F-FDG PET/CT combined with clinical characteristics in treated patients with esophageal squamous cell carcinoma

Related Author

CHEN Xin-huan

Tang Mingmei

Yu Bin

Liu Hui

Pan Yuanrui

Zhang Ke

Lü Fajin

Li Miaoyu

Related Institution

Department of Surgerg,the Second People’Hospotal of Qinzhou

State Key Laboratory of Ultrasound in Medicine and Engineering，College of Biomedical Engineering，Chongqing Medical University

Department of Radiology，The First Affiliated Hospital of Chongqing Medical University

Department of Hematology，the First Affiliated Hospital of Air Force Medical University

Department of Neurology，The First Affiliated Hospital of Anhui Medical University

⁰