The predictive value of Liver Imaging Reporting and Data System with contrast-enhanced ultrasound (v2017) in the risk of hepatocellular carcinoma in high-risk population
10.3760/cma.j.issn.1004-4477.2020.02.007
- VernacularTitle:超声造影肝脏影像报告与数据系统对高危人群肝细胞癌的风险预测
- Author:
Jianmin DING
1
;
Lei LONG
;
Hongyu ZHOU
;
Yan ZHOU
;
Yandong WANG
;
Xiang JING
Author Information
1. 天津市第三中心医院超声科，天津市肝胆疾病研究所，天津市人工细胞重点实验室，卫生部人工细胞工程技术研究中心 300170
- From:
Chinese Journal of Ultrasonography
2020;29(2):138-142
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the clinical value of Liver Imaging Reporting and Data System (LI-RADS) version 2017 with contrast-enhanced ultrasound (CEUS) for the risk prediction of hepatocellular carcinoma (HCC).Methods:Five hundred and seventy-one patients with HCC risk factors had received CEUS examination in Tianjin Third Central Hospital, 270 patients with 295 nodules were enrolled in this study according to the inclusion criteria. The final diagnostic reference standard was decided by surgical pathology or ultrasound-guided biopsy pathology. Each nodule was classified according to CEUS LI-RADS v2017. The diagnostic accuracy of CEUS LI-RADS v2017 for the prediction of HCC was analyzed retrospectively.Results:Of all 295 nodules, 95 nodules were diagnosed by surgical pathology and 200 nodules by ultrasoud-guided biopsy pathology, among which with 245 HCC, 13 intrahepatic cholangiocarcinoma (ICC), 8 combined hepatocellular cholangiocarcinoma(CHC), 2 metastatic neoplasm of other cellular origin and 27 benign nodules.The numbers of LR-3, LR-4, LR-5 and LR-M categories were 16(5.4%), 28(9.5%), 183(62.0%), 68(23.1%) and the positive predictive value (PPV) of LR-3, LR-4 and LR-5 were 43.8%, 60.7%, 98.4% for HCC, respectively. The sensitivity, specificity and positive predictive value of LR-5 category for HCC were 73.5%, 94.0%, 98.4%, respectively. 60.3%(41/68) LR-M category nodules were pathologically confirmed to be HCC.Conclusions:CEUS LI-RADS v2017 classification standard has reliable risk prediction value for patients with high risk factors of HCC, of which the LR-5 category has higher PPV for HCC. However, the differential diagnosis between HCC and other non-HCC malignancies still remains to be further studied for LR-M observations.
