ObjectiveTo systematically summarize the research progress of multiparametric magnetic resonance imaging (mpMRI) in assessing tumor microenvironment (TME) heterogeneity in hepatocellular carcinoma (HCC), and to discuss its future development directions, limitations, and challenges. MethodsA comprehensive review was conducted to review domestic and international research progress on the use of mpMRI techniques in evaluating TME heterogeneity in HCC. ResultsmpMRI techniques can reflect TME heterogeneity features associated with postoperative recurrence in HCC from multiple perspectives, including cellular structure, function, substance metabolism, and neovascularization. These features encompass structural heterogeneity, cellular composition heterogeneity, and metabolic heterogeneity within the TME. mpMRI emerges as a potential tool for TME heterogeneity assessment, offering advantages such as non-invasiveness, absence of radiation exposure, and excellent reproducibility. However, the application of mpMRI in evaluating TME heterogeneity in HCC is still in its preliminary stages. Most studies have not conducted in-depth and systematic explorations of the specific pathological and biological mechanisms closely related to TME heterogeneity when utilizing mpMRI. This limitation significantly restricts the further clinical translation of relevant findings and necessitates further research for confirmation. ConclusionsmpMRI hold immense potential and promising application prospects in assessing TME heterogeneity in HCC, offering greater benefits for prognosis evaluation and individualized management of HCC patients. However, further exploration of the related pathological and biological mechanisms is essential to facilitate its clinical translation.
