建立和验证使用计算机断层扫描（CT）和磁共振成像（MRI）预测肝细胞癌（HCC）中血管包裹肿瘤簇（VETC）的评分模型，并在个体内比较两种模式之间的预测性能。回顾性纳入 324 例经手术确诊的 HCC 患者，这些患者在 2019 年 6 月至 2020 年 8 月期间接受了术前动态 CT 和 MRI 细胞外造影剂。然后将这些患者分为发现队列 (n = 227) 和验证队列 (n = 97)。对 VETC 阳性 HCC 的影像学特征和肝脏影像报告和数据系统 (LI-RADS) 类别进行了评估。对发现队列进行逻辑回归分析，以确定与 VETC 阳性病例相关的临床和影像学预测因素。随后，开发了单独的基于 CT 和 MRI 的评分模型，并使用广义估计方程比较了它们的诊断性能。在 CT 和 MRI 上，VETC 阳性 HCC 表现出较高的尺寸 > 5.0 cm、坏死或严重缺血的频率与 VETC 阴性 HCC 相比，肿瘤边缘不光滑、靶样外观、肿瘤内动脉以及具有间隔或不规则环状结构的不均匀强化（所有 p<0.05）。关于 LI-RADS 类别，VETC 阳性 HCC 比 VETC 阴性病例更常被归类为 LR-M（所有 p<0.05）。在验证队列中，基于 CT 的模型显示出相似的敏感性（76.7% vs. 86.7%，p = 0.375）、特异性（83.6% vs. 74.6%，p = 0.180）和曲线下面积值（0.80 vs. 0.80）。 0.81, p = 0.910) 与基于 MRI 的模型在预测 VETC 阳性 HCC 方面的差异。术前 CT 和 MRI 在识别 VETC 阳性 HCC 方面表现出相当的性能，从而显示出有希望的预测能力。计算机断层扫描和磁共振成像都显示出前景在术前识别肝细胞癌中血管包膜肿瘤簇模式方面，两种方式之间没有统计学上的显着差异，可能增加额外的预后价值。计算机断层扫描（CT）和磁共振成像（MRI）在术前识别血管方面显示出希望包膜肿瘤簇阳性肝细胞癌（HCC）。与没有血管的 HCC 相比，具有包裹肿瘤簇模式的 HCC 更常见 LR-M。这些 CT 和 MRI 模型在识别包裹肿瘤簇阳性 HCC 的血管方面表现出相当的能力。© 2024。作者，获得欧洲放射学会的独家许可。

To establish and validate scoring models for predicting vessels encapsulating tumor clusters (VETC) in hepatocellular carcinoma (HCC) using computed tomography (CT) and magnetic resonance imaging (MRI), and to intra-individually compare the predictive performance between the two modalities.We retrospectively included 324 patients with surgically confirmed HCC who underwent preoperative dynamic CT and MRI with extracellular contrast agent between June 2019 and August 2020. These patients were then divided into a discovery cohort (n = 227) and a validation cohort (n = 97). Imaging features and Liver Imaging Reporting and Data System (LI-RADS) categories of VETC-positive HCCs were evaluated. Logistic regression analyses were conducted on the discovery cohort to identify clinical and imaging predictors associated with VETC-positive cases. Subsequently, separate CT-based and MRI-based scoring models were developed, and their diagnostic performance was compared using generalized estimating equations.On both CT and MRI, VETC-positive HCCs exhibited a higher frequency of size > 5.0 cm, necrosis or severe ischemia, non-smooth tumor margin, targetoid appearance, intratumor artery, and heterogeneous enhancement with septations or irregular ring-like structure compared to VETC-negative HCCs (all p < 0.05). Regarding LI-RADS categories, VETC-positive HCCs were more frequently categorized as LR-M than VETC-negative cases (all p < 0.05). In the validation cohort, the CT-based model showed similar sensitivity (76.7% vs. 86.7%, p = 0.375), specificity (83.6% vs. 74.6%, p = 0.180), and area under the curve value (0.80 vs. 0.81, p = 0.910) to the MRI-based model in predicting VETC-positive HCCs.Preoperative CT and MRI demonstrated comparable performance in the identification of VETC-positive HCCs, thus displaying promising predictive capabilities.Both computed tomography and magnetic resonance imaging demonstrated promise in preoperatively identifying the vessel-encapsulating tumor cluster pattern in hepatocellular carcinoma, with no statistically significant difference between the two modalities, potentially adding additional prognostic value.Computed tomography (CT) and magnetic resonance imaging (MRI) show promise in the preoperative identification of vessels encapsulating tumor clusters-positive hepatocellular carcinoma (HCC). HCC with vessels encapsulating tumor cluster patterns were more frequently LR-M compared to those without. These CT and MRI models showed comparable ability in identifying vessels encapsulating tumor clusters-positive HCC.© 2024. The Author(s), under exclusive licence to European Society of Radiology.