To explore the application value of dynamic contrast-enhanced MRI(DCE-MRI)and diffusion-weighted imaging(DWI)in prognosis evaluation in advanced hepatocellular carcinoma based on DCE-MRI and DWI findings before and after immunotherapy.

A retrospective analysis was performed on the case data of 100 patients with advanced hepatocellular carcinoma who underwent immunotherapy in Harbin Medical University Cancer Hospital between January 2018 and July 2022.All patients underwent DCE-MRI and DWI scans before and after immunotherapy, and they were regularly followed up after discharge.The correlation between DCE-MRI, DWI findings and prognosis after immunotherapy was analyzed.

In the 100 patients during follow-up, there were 63 death cases and 37 survival cases.The overall survival rate and median survival time were 37% and 19 months, respectively.MRI findings: irregular edges in tumors, fast-in and fast-out enhancement in lesion edges.For larger lesions, there were often uneven signals, indicating necrosis, liquefaction, bleeding or calcification.There was limitation of DWI diffusion.There were significant differences in number of tumors, tumor edges, fast-in and fast-out enhancement, internal necrosis and limitation of DWI diffusion between the survival group and the death group(P<0.05). The results of Cox multivariate regression analysis showed that irregular edges in tumors, fast-in and fast-out enhancement, internal necrosis and limitation of DWI diffusion were independent risk factors of prognosis in patients with advanced hepatocellular carcinoma after immunotherapy(P<0.05).

In DCE-MRI and DWI findings from patients with advanced hepatocellular carcinoma, irregular edges in tumors, fast-in and fast-out enhancement, internal necrosis and limitation of DWI diffusion are closely related to prognosis after immunotherapy.