初探超声造影基于LI-RADS分类标准诊断肝细胞癌的可行性 |
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引用本文: | 沈若霞,张圆,邵晖,年英华,姚南,王关顺.初探超声造影基于LI-RADS分类标准诊断肝细胞癌的可行性[J].放射学实践,2016(4):311-315. |
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作者姓名: | 沈若霞 张圆 邵晖 年英华 姚南 王关顺 |
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作者单位: | 1. 昆明医科大学第三附属医院云南省肿瘤医院超声科, 昆明,650118;2. 昆明医科大学第三附属医院云南省肿瘤医院放射科, 昆明,650118 |
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基金项目: | 云南省教育厅基金(2014Y169);云南省科技厅-昆明医科大学应用基础研究联合专项基金(2014FB062,2015FB071) |
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摘 要: | 目的:探讨基于肝脏影像报告和数据管理系统(LI-RADS)的超声造影检查诊断肝细胞癌(HCC)的可行性。方法:回顾性分析108例有肝癌高风险的单发肝脏病变患者的超声造影资料,并基于LI-RADS分类标准对肝脏病变进行分析评估,并与病理或临床诊断结果相对照。结果:108个病灶中LI-RADS 1~5类病灶共106个:1类和2类病灶19个,临床客观诊断结果均为良性(阴性预测值为100%);3类病灶3个;22个4类病灶中17个为 HCC(阳性预测值为77.3%);62个5类病灶中有54个为 HCC(阳性预测值为87.1%)。受试者工作特征(ROC)曲线下面积为0.83(P<0.001)。若将LI-RADS 3~5类病灶归为阳性,基于LI-RADS的超声造影检查对HCC的诊断符合率为83.9%(92/106),敏感度为100%(73/73),特异度为57.6%(19/33),阳性预测值为83.9%(73/87),阴性预测值为100%(19/19);若将 LI-RADS 3类病灶排除、1~2类病灶归为阴性、4~5类病灶归为阳性,则诊断符合率为87.4%(90/103),敏感度为100%(71/71),特异度为59.4%(19/32),阳性预测值为84.5%(71/84),阴性预测值为100%(19/19)。结论:超声造影检查中应用LI-RADS分类标准诊断 HCC具有一定的可行性。
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关 键 词: | 肝脏影像报告和数据管理系统 肝肿瘤 肝细胞癌 超声成像 对比增强 诊断效能 |
LI-RADS with contrast-enhanced ultrasound for diagnosis of hepatocellular carcinoma (HCC):apreliminarystudy |
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Institution: | SHEN Ruo-xia;ZHANG Yuan;SHAO Hui;Department of Ultrasound,the Third Hospital of Kunming Medical University,Cancer Hospital of Yunnan Province; |
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Abstract: | Objective:To explore the feasibility of liver imaging reporting and data system (LI-RADS)with contrast-enhanced ultrasound for diagnosis of hepatocellular carcinoma (HCC ).Methods:The contrast-enhanced ultrasound (CEUS)data of 108 patients at high risk of HCC were retrospectively analyzed using LI-RADS.The diagnostic results of CEUS were compared with the results of clinical objective diagnosis.Sensitivity,specificity,negative (NPV)and positive predictive values (PPV),and receiver operating characteristic (ROC)curve were then produced.Results:108 lesions were found by CEUS including 106 lesions in LI-RADS category 1~5:19 lesions oincategory 1 or 2 were all benign (NPV=100%);there were 3 lesions in category 3;of 22 lesions in category 4,there were 17 HCCs (PPV= 77.3%);of 62 lesions in category 5,there were 54 HCCs (PPV= 87.1%).The area underneath the ROC curve was 0.83 with statistic significance (P<0.001).If category 1 and 2 were considered as negative and category 3~5 were considered as positive,the accuracy, sensitivity,specificity,PPV and NPV of CEUS based on the LI-RADS classification for the diagnosis of HCC were 83 .9%, 100%,57.6%,83.9% and 100% respectively.If the lesions in category 3 were excluded,and category 1 and 2 were con-sidered as negative,category 4~5 were considered as positive,the accuracy,sensitivity,specificity,PPV and NPV of CEUS based on the LI-RADS classification for diagnosis of HCC were 87.4%,100%,59.4%,84.5%and 100% respectively.Con-clusion:Contrast-enhanced ultrasound based on LI-RADS is feasible for diagnosis of HCC. |
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Keywords: | Liver imaging reporting and data system Liver neoplasms Hepatocellular carcinoma Contrast-en-hanced Ultrasound Diagnostic efficacy |
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