To analyze the correlation between multimodal parameters of gadoxetic acid disodium (Primovist) enhanced MRI and the severity of primary hepatocellular carcinoma in patients.

A total of 90 patients with primary hepatocellular carcinoma admitted to Xianyang Central Hospital from October 2021 to October 2022 were included as the study subjects, all patients underwent Primovist enhanced MRI examination and underwent Child Pugh grading of liver function, disease grading, vascular infiltration, and prognosis quality evaluation, and the correlation between MRI multimodal quantitative parameters [apparent diffusion coefficient (ADC), true diffusion coefficient (D), perfusion related diffusion coefficient (D*), perfusion fraction (f), rate constant (K_ep), volume transfer constant (K^trans), and percentage of extracellular space volume (V_e)] and patient disease severity (liver function, disease grading, vascular infiltration, prognosis quality) was analyzed.

There were statistically significant differences in ADC, D, D*, f, K_ep, K^trans and V_e among patients with different Child-Pugh grades of liver function and disease stages (P<0.05). ADC and D in the non-invasive group were higher than those in the vascular invasion group, and D*, f, K^trans, K_ep and V_e were higher than those in the vascular invasion group (P<0.05). ADC and D in the good prognosis group were higher than those in the poor prognosis group; D*, f, K^trans, K_ep, V_e were higher than those in the poor prognosis group; ADC and D in the death group were lower than those in the survival group; D*, f, K^trans, K_ep, V_e were higher than those in the survival group (P<0.05). According to Spearman model, ADC and D values were negatively correlated with liver function grade, disease stage, vascular infiltration and prognostic quality (P<0.05), while D*, f, K_ep and V_e values were positively correlated with them (P<0.05). Logistic multivariate regression analysis showed that ADC<1.6×10^-3 mm²/s, D<1.45×10^-3 mm²/s, D*≥59×10^-3 mm²/s, f≥25%, K_ep≥1.35/min, K^trans≥0.41/min, V_e≥0.36 were all risk factors affecting poor prognosis of patients with primary hepatocellular carcinoma (P<0.05). Combined ADC, D, D*, f, K_ep, K^trans and V_e predicted the AUC of poor prognosis in patients with primary hepatocellular carcinoma was 0.936, and the sensitivity and specificity were 91.89% and 89.69% (P<0.05).

The multimodal quantitative parameters of Primovist-enhanced MRI exhibits a significant correlation with liver function, disease grading, vascular invasion, and quality of prognosis in patients, these parameters are instrumental in assessing the severity of the disease and provide a more reliable imaging reference for predicting patient prognosis.