| 摘要: |
| 目的 探讨肝脏影像报告和数据管理系统（LI-RADS）超声造影分类标准诊断肝细胞癌的诊断效能。方法 选取具有肝细胞癌高危因素的肝脏局灶性病变患者129例（共148个病灶），均行超声造影检查，以病理组织学诊断或最终临床诊断为标准，计算LI-RADS标准诊断HCC的敏感性、特异性、阳性预测值及阴性预测值；绘制受试者工作特征曲线并计算其曲线下面积。结果 LR-1类和LR-2类病灶35个，LR-3、LR-4、LR-5类病灶76个（LR-3类9个，LR-4类24个，LR-5类43个），LR-M类病灶37个。LR-1类和LR-2类病灶临床诊断均为良性；LR-3、LR-4、LR-5类病灶中，67个为肝细胞癌；LR-M类病灶中，1个为肝细胞癌。将LR-1和 LR-2类归为阴性，LR-3、LR-4、LR-5类归为阳性或LR-4、LR-5类归为阳性，其诊断肝细胞癌的敏感性分别为100%、100%，特异性分别为79.5%、87.5%，阳性预测值为88.2%、92.5%；曲线下面积分别为0.949和0.952。结论 LI-RADS分类标准为超声造影的标准化评估和规范报告提供了参考标准，对肝细胞癌具有较好的诊断效能。 |
| 关键词: 超声检查 造影剂 肝细胞癌 肝脏影像报告和数据管理系统 |
| DOI： |
| 投稿时间：2017-01-11修订日期：2017-07-16 |
| 基金项目:国家自然科学基金面上项目(81671701) |
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| Diagnostic efficacy of liver imaging reporting and data system for hepatocellular carcinoma on contrast-enhanced ultrasound |
| hanhao |
| (Nanjing Drum Tower Hospital) |
| Abstract: |
| Objective To investigate the utility of Liver Imaging Reporting and Data System （LI-RADS） v2016 for hepatocellular carcinoma （HCC） on contrast-enhanced ultrasound （CEUS）. Methods 129 patients (148 nodules) at risk with HCC were included in this study. All patients were examined by convention ultrasound and CEUS, the images were reviewed according to the LI-RADS categorization. Results were compared to histology and/or clinical diagnosis as reference standards. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and the area under the ROC curve in the diagnosis of HCC with the LI-RADS categorization were calculated. Results 35 nodules were initially assigned as LR-1 or LR-2, 9 nodules were initially assigned as LR-3, 24 nodules were initially assigned as LR4, 43nodules were initially assigned as LR-5, 37 nodules were initially assigned as LR-M. 35 nodules in category 1 or 2 were benign nodules proved by clinical diagnosis. Of 76 nodules in category LR-3~5, there were 67 HCCs. Of 37 nodules in category LR-M, there was 1 HCC. If LR1 and LR2 were considered negative, and LR-3, 4, 5 were positive, then the sensitivity, the specificity and the PPV was 100%, 79.5% and 88.2%，respectively. If LR-1 and LR-2 were considered negative and LR-4, 5 were positive, the sensitivity, the specificity and the PPV was 100%, 87.5% and 92.5%, respectively. The area under the ROC curve were 0.949 and 0.952 respectively. Conclusions LI-RADS-CEUS offers a CEUS algorithm for standardized assessment and reporting of liver nodules in patients at risk with HCC，it is demonstrated as a valuable tool for the diagnosis of HCC. |
| Key words: ultrasound contrast agent hepatocellular carcinoma LI-RADS |
