为了研究通过钆珠葡胺增强磁共振成像（MRI）所得定量参数对肝细胞癌（HCC）的分子亚型和总体生存预测的价值。这项多中心回顾性研究纳入了218例进行钆珠葡胺增强MRI的单发HCC患者。所有的HCC病变经切除并经病理学确认。在肝胆相期内测量了病变与肝组织的对比增强比率（LLCER）和病变与肝组织的对比增强（LLC）。采用逻辑回归评估了增殖性HCC的潜在风险因素。采用受试者工作特征曲线（ROC曲线）评估LLCER和LLC对增殖性HCC的预测能力。采用Cox比例风险回归模型评估了预后因素对生存结果的影响。LLCER是增殖性HCC的独立预测因子（比值比0.015；95%置信区间[CI]，0.008-0.022；p < 0.001）。ROC曲线下面积为0.812（95%CI，0.748-0.877），高于LLC、α-胎蛋白 > 100 ng/ml、卫星结节和边缘动脉期高增强（均p ≤ 0.001）。LLCER < -4.59%的HCC患者增殖性HCC的发生率明显高于LLCER ≥ -4.59%的患者。LLCER是HCC患者总体生存的独立预测因子（危险比0.070；95%CI，0.015-0.324；p = 0.001）。在肝胆相期，钆珠葡胺增强的定量参数可以以较高的准确性预测单发HCC的增殖性亚型。来自钆珠葡胺增强MRI的定量信息可以为肝细胞癌的亚型提供关键信息。这对于设计新型治疗策略，如靶向治疗或免疫治疗可能具有价值。• 病变与肝组织的对比增强比率（LLCER）是预测增殖性肝细胞癌（HCC）的独立因子。• LLCER相较于病变与肝组织的对比增强、α-胎蛋白 > 100 ng/ml、卫星结节和边缘动脉期高增强具有更好的预测增殖性HCC的能力。• LLCER < -4.59%的HCC患者的增殖性HCC发生率明显高于LLCER ≥ -4.59%的患者。© 2023. 作者，在欧洲放射学协会独家许可下。

To investigate the value of quantitative parameters derived from gadobenate dimeglumine-enhanced magnetic resonance imaging (MRI) for predicting molecular subtype of hepatocellular carcinoma (HCC) and overall survival.This multicenter retrospective study included 218 solitary HCC patients who underwent gadobenate dimeglumine-enhanced MRI. All HCC lesions were resected and pathologically confirmed. The lesion-to-liver contrast enhancement ratio (LLCER) and lesion-to-liver contrast (LLC) were measured in the hepatobiliary phase. Potential risk factors for proliferative HCC were assessed by logistic regression. The ability of LLCER and LLC to predict proliferative HCC was assessed by the receiver operating characteristic (ROC) curve. Prognostic factors were evaluated using the Cox proportional hazards regression model for survival outcomes.LLCER was an independent predictor of proliferative HCC (odds ratio, 0.015; 95% confidence interval [CI], 0.008-0.022; p < 0.001). The area under the ROC curve was 0.812 (95% CI, 0.748-0.877), higher than that of LLC, alpha-fetoprotein > 100 ng/ml, satellite nodules, and rim arterial phase hyperenhancement (all p ≤ 0.001). HCC patients with LLCER < -4.59% had a significantly higher incidence of proliferative HCC than those with the LLCER ≥ -4.59%. During the follow-up period, LLCER was an independent predictor of overall survival (hazard ratio, 0.070; 95% CI, 0.015-0.324; p = 0.001) in HCC patients.Gadobenate dimeglumine-enhanced quantitative parameter in the hepatobiliary phase can predict the proliferative subtype of solitary HCC with a moderately high accuracy.Quantitative information from gadobenate dimeglumine-enhanced MRI can provide crucial information on hepatocellular carcinoma subtypes. It might be valuable to design novel therapeutic strategies, such as targeted therapies or immunotherapy.• The lesion-to-liver contrast enhancement ratio (LLCER) is an independent predictor of proliferative hepatocellular carcinoma (HCC). • The ability of LLCER to predict proliferative HCC outperformed lesion-to-liver contrast, alpha-fetoprotein > 100 ng/ml, satellite nodules, and rim arterial phase hyperenhancement. • HCC patients with LLCER < -4.59% had a significantly higher incidence of proliferative HCC than those with the LLCER ≥ -4.59%.© 2023. The Author(s), under exclusive licence to European Society of Radiology.