| 摘要: |
| 目的 探究超声造影肝脏影像报告和数据管理系统(CEUS LI-RADS)在诊断病灶直径≤3cm的肝脏局灶性病变(FLLs)性质中的临床价值。方法 以2019年7月~2022年11月82例肝脏局灶性病变患者为研究对象,患者同时接受常规超声及超声造影检查。以病理学检查结果为参考标准,分析CEUS LI-RADS及常规超声对良恶性FLLs的诊断价值,并比较CEUS LI-RADS对不同直径FLLs的诊断准确率。结果 经病理学检查显示,82例FLLs患者中包括良性病变3例(肝非典型性孤立性纤维肿瘤2例、肝血管瘤1例)、恶性病变79例(肝细胞癌(HCC)40例、胆管细胞癌14例、转移癌23例、多形性横纹肌肉瘤1例、上皮样血管肉瘤1例)；LI-RADS诊断FLLs的准确率为90.24%(74/82)；CEUS LI-RADS与病理学检查结果的一致性(kappa=0.553)高于常规超声(Kappa=0.266)；CEUS LI-RADS诊断肝脏良恶性病变的AUC大于常规超声(P<0.05)；CEUS LI-RADS诊断直径2~3cm 、1~<2cm及<1cm FLLs的准确率分别为94.74%(36/38)、91.18%(31/34)、70.00%(7/10),其诊断直径2~3cm FLLs的准确率高于直径<1cm FLLs(χ2=5.191,P=0.023)。结论 CEUS LI-RADS可用于判断FLLs恶性概率,且LI-RADS LR-5类对恶性FLLs具有诊断价值。 |
| 关键词: 超声造影肝脏影像报告和数据管理系统 肝脏局灶性病变 直径≤3cm 病灶性质 |
| DOI： |
| 投稿时间：2023-01-19修订日期：2023-09-12 |
| 基金项目: |
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| Clinical value of CEUS LI-RADS in the diagnosis of properties of focal liver lesions with diameter≤3 cm |
| maoyuxiang |
| () |
| Abstract: |
| Objective To explore the clinical value of contrast-enhanced ultrasound liver imaging reporting and data system (CEUS LI-RADS) in the diagnosis of properties of focal liver lesions (FLLs) with diameter≤3 cm. Methods 82 patients with FLLs from July 2019 to November 2022 were selected as the study subjects. All patients underwent conventional ultrasound and contrast-enhanced ultrasound. Taking pathological examination result as the reference standard, the diagnostic value of CEUS LI-RADS and conventional ultrasound on benign and malignant FLLs was analyzed, and the diagnostic accuracy rate of CEUS LI-RADS on FLLs with different diameters was compared. Results Pathological examination showed that there were 3 cases of benign lesions (2 cases f atypical liver solitary fibrous tumors, 1 case of hepatic hemangioma) and 79 cases of malignant lesions [40 cases of hepatocellular carcinoma (HCC), 14 cases of cholangiocarcinoma, 23 cases of metastatic carcinoma, 1 case of pleomorphic rhabdomyosarcoma, 1 case of epithelioid angiosarcoma). The accuracy rate of LI-RADS in diagnosing FLLs was 90.24% (74/82). The consistency of CEUS LI-RADS with pathological examination result (kappa=0.553) was higher than that of conventional ultrasound (Kappa=0.266). The AUC of CEUS LI-RADS in the diagnosis of benign and malignant liver lesions was greater than that of conventional ultrasound (P<0.05). The accuracy rates of CEUS LI-RADS in the diagnosis of FLLs with diameters of 2-3cm, 1-2cm and <1cm were 94.74% (36/38), 91.18% (31/34) and 70.00% (7/10) respectively. The accuracy rate of CEUS LI-RADS in the diagnosis of FLLs with diameter of 2-3cm was higher than that in the diagnosis of FLLs with diameter< 1cm (χ2=5.191, P=0.023). Conclusion CEUS LI-RADS can be used to judge the malignant probability of FLLs, and LI-RADS LR-5 has diagnostic value on malignant FLLs. |
| Key words: Contrast-enhanced ultrasound liver imaging reporting and data system Focal liver lesions Diameter ≤ 3cm Lesion properties |
