| 摘要: |
| 目的 研究超声造影肝脏影像报告与数据系统2017版（CEUS LI-RADS
v2017）在甲胎蛋白（AFP）阴性的肝细胞癌（HCC）高危患者肝局灶性病变中的应用价值。方法 回顾性分析2018年1月至2021年10月在我院行CEUS检查的AFP阴性HCC高危患者108例（134个结节），采用CEUS LI-RADS v2017对结节进行分类，以组织病理学结果或增强影像学检查和随访结果为金标准，计算CEUS LI-RADS对AFP阴性患者HCC和肝内其他恶性肿瘤（OM）的诊断敏感性、特异性、阳性预测值、阴性预测值、准确率、受试者工作特征曲线下面积（AUC）。结果 AFP阴性HCC较OM小（P＜0.001）。CEUS LR-5类、LR-4类、LR-3类对AFP阴性HCC的阳性预测值分别为88.37%、47.06%、12.9%。LR-5类诊断AFP阴性HCC的敏感性、特异性、准确率和AUC分别为73.07%、 93.90%、85.82%和0.87。LR-M类诊断OM的敏感性、特异性、阳性预测值、阴性预测值、准确率和AUC分别为90.91%、97.32%、86.96%、98.20%、96.27%和0.94。结论AFP阴性HCC较OM小，CEUS LI-RADS v2017对AFP阴性HCC诊断特异性较高而敏感性较低，对OM有较好的诊断价值。 |
| 关键词: 甲胎蛋白 肝细胞癌 超声检查 造影剂 肝脏影像报告与数据系统 |
| DOI： |
| 投稿时间：2022-05-18修订日期：2022-07-02 |
| 基金项目: |
|
| Application of contrast-enhanced ultrasound liver imaging reporting and data system in high-risk patients with alpha-fetoprotein- negative hepatocellular carcinoma |
| ZHENG Lili,REN Xinping,ZHAN Weiwei,FENG Meijing,LI Junjian |
| () |
| Abstract: |
| Objective To investigate the application of contrast-enhanced ultrasound liver imaging reporting and data system version 2017 (CEUS LI-RADS v2017)for focal liver lesions in high-risk patients with alpha-fetoprotein(AFP)-negative. Methods From January 2018 to October 2021,134 focal liver lesions in 108 high-risk patients with AFP-negative who underwent contrast-enhanced ultrasound were retrospectively analyzed. Nodules were categorized according to the CEUS LI-RADS v2017.The reference standard was histopathology or contrast-enhanced imaging and follow-up.The sensitivity, specificity, positive predictive value, negative predictive value, accuracy and area under the curve (AUC)of CEUS LI-RADS for HCC and other malignant tumors (OM) in AFP-negative patients were calculated. Results AFP-negative HCC was smaller than OM (P< 0.001). The positive predictive values of AFP-negative HCC in LR-5, LR-4, and LR-3 were88.37%,47.06% and 12.9%,respectively.The sensitivity, specificity,accuracy and AUC of LR-5 for AFP-negative HCC were 73.07%,93.90%,85.82% and 0.87,respectively.The sensitivity,specificity,positive predictive value, negative predictive value,accuracy and AUC of LR-M for OM were 90.91%,97.32%,86.96%,98.20%,96.27% and 0.94, respectively. Conclusions AFP-negative HCC was smaller than OM. CEUS Li-RADS v2017 shows high specificity and low sensitivity for AFP-negative HCC and good diagnostic efficiency for OM. |
| Key words: Alpha-fetoprotein Hepatocellular carcinoma Ultrasonography Contrast agent Liver imaging reporting and data system |
