Abstract:To investigate the MRI findings of pseudoenvelope integrity in hepatocellular carcinoma (HCC) and to predict the biological characteristics (pathological grade, portal vein embolus, preoperative intrahepatic metastasis, postoperative recurrence, postoperative intrahepatic metastasis) and further evaluate the clinical prognosis. Methods A retrospective analysis was conducted on HCC cases confirmed by surgical pathology in our hospital and examined by dynamic contrast-enhanced MRI scan within 1 month before surgery from January 2018 to December 2019. Fifty-hree HCC patients with more than half a year of postoperative follow-up were selected. Preoperative MRI images of the patients were analyzed. According to the presence or absence of pseudocapsule and the integrity of the pseudocapsule, they were divided into complete pseudocapsule, partial and no pseudocapsule. The correlation between HCC capsule integrity and portal vein cancer thrombus, preoperative intrahepatic metastasis, pathological grade, postoperative recurrence, and postoperative intrahepatic metastasis were evaluated. Results Fifty three patients with HCC had 54 tumor lesions. On MRI images, there were 20 cases (37.0%) with complete capsule, 2 cases (10.0%) with portal vein cancer thrombus, 4 cases (20.0%)with preoperative intrahepatic metastasis,4 cases (20.0%) with postoperative recurrence, 2 cases (10.0%) with postoperative intrahepatic metastasis. There were 34 cases (63.0%) with partial or no capsule, including 12 cases (35.3%) with portal vein cancer thrombus, 10 cases(29.4%) with preoperative intrahepatic metastasis, 18 cases (52.9%) with postoperative recurrence, 21 cases (61.8%) with postoperative intrahepatic metastasis. There were significant differences between HCC capsule integrity and portal vein thrombus, postoperative recurrence, and postoperative intrahepatic metastasis rate, with statistical significance (P<0.05). There was no significant difference in the preoperative intrahepatic metastasis rate and pathological grade(P>0.05) .According to pathological classification, 10 cases were highly differentiated, 37 cases were moderately differentiated, and 7 cases were poorly differentiated. The percentages of high, medium and low HCC cases with false capsule integrity were 50.0%, 35.1% and 28.6%, respectively,and the percentages of partial and no false capsule were 50.0%, 64.9% and 71.4%, respectively. Although the false capsule integrity rate of HCC had a decreasing trend with the decrease of HCC pathological classification, there was no statistically significant difference between the three groups (P=0.609). Conclusion MRI manifestations of capsular integrity of HCC tumor can be used to evaluate the clinical prognosis of HCC to a certain extent, but cannot be used as a predictor of pathological grade.