ĐẶC ĐIỂM HÌNH ẢNH CỘNG HƯỞNG TỪ CỦA UNG THƯ BIỂU MÔ TẾ BÀO GAN ĐỐI CHIẾU VỚI KẾT QUẢ GIẢI PHẪU BỆNH

Abstract

Objectives: To describe the magnetic resonance imaging (MRI) features of hepatocellular carcinoma (HCC) and to evaluate the diagnostic value of MRI through correlation with histopathological findings. Methods: This retrospective cross-sectional study included 46 patients diagnosed with HCC at Ha Dong General Hospital between January 2023 and August 2025. All patients underwent liver MRI on a 1.5 Tesla system using the study protocol. MRI findings were correlated with histopathology in 39 cases; the remaining 7 cases met the diagnostic criteria based on imaging findings and alpha-fetoprotein levels according to the Ministry of Health guidelines. Results: The majority of patients were male (93%), with a mean age of 62.7 ± 11.6 years. Solitary HCC accounted for 76% of cases, predominantly located in the right hepatic lobe (82.5%); 85% of tumors measured ≤ 50 mm in diameter. Signal characteristics included hyperintensity on T2-weighted images in 95.5%, hypointensity on T1-weighted images in 90%, and diffusion restriction with high signal on diffusion-weighted imaging and low apparent diffusion coefficient values in 98% of cases. Contrast enhancement patterns showed arterial phase hyperenhancement in 98.9%, washout in the portal venous phase in 92.5%, and delayed phase washout in 95.5%. Malignant portal vein thrombosis was observed in 19.6% of cases, of which 77% demonstrated enhancement patterns similar to the primary tumor. MRI findings were concordant with histopathological results in 89% of cases, with diagnostic accuracy increasing with tumor size (<20 mm: 80%; 20–50 mm: 93%; >50 mm: 100%). Conclusions: MRI demonstrates high diagnostic value in the detection of hepatocellular carcinoma and malignant portal vein thrombosis, and should be routinely utilized in the evaluation of liver lesions suspicious for HCC.