Sugimoto Katsutoshi, Kakegawa Tatsuya, Takahashi Hiroshi, Tomita Yusuke, Abe Masakazu, Yoshimasu Yu, Takeuchi Hirohito, Kasai Yoshitaka, Itoi Takao
Department of Gastroenterology and Hepatology, Tokyo Medical University, Tokyo 160-0023, Japan.
Diagnostics (Basel). 2020 Oct 15;10(10):828. doi: 10.3390/diagnostics10100828.
The Contrast-Enhanced Ultrasound Liver Imaging Reporting and Data System (CEUS LI-RADS) was introduced for classifying suspected hepatocellular carcinoma (HCC). However, it cannot be applied to Sonazoid. We assessed the diagnostic usefulness of a modified CEUS LI-RADS for HCC and non-HCC malignancies based on sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV). Patients with chronic liver disease at risk for HCC were evaluated retrospectively. Nodules ≥1 cm with arterial phase hyperenhancement, no early washout (within 60 s), and contrast defects in the Kupffer phase were classified as LR-5. Nodules showing early washout, contrast defects in the Kupffer phase, and/or rim enhancement were classified as LR-M. A total of 104 nodules in 104 patients (median age: 70.0 years; interquartile range: 54.5-78.0 years; 74 men) were evaluated. The 48 (46.2%) LR-5 lesions included 45 HCCs, 2 high-flow hemangiomas, and 1 adrenal rest tumor. The PPV of LR-5 for HCC was 93.8% (95% confidence interval (CI): 82.8-98.7%). The 22 (21.2%) LR-M lesions included 16 non-HCC malignancies and 6 HCCs. The PPV of LR-M for non-HCC malignancies, including six intrahepatic cholangiocarcinomas, was 100% (95% CI: 69.8-100%). In conclusion, in the modified CEUS LI-RADS for Sonazoid, LR-5 and LR-M are good predictors of HCC and non-HCC malignancies, respectively.
对比增强超声肝脏成像报告和数据系统（CEUS LI-RADS）被引入用于对疑似肝细胞癌（HCC）进行分类。然而，它不能应用于Sonazoid。我们基于敏感性、特异性、阳性预测值（PPV）和阴性预测值（NPV）评估了改良的CEUS LI-RADS对HCC和非HCC恶性肿瘤的诊断效用。对有HCC风险的慢性肝病患者进行了回顾性评估。直径≥1 cm且动脉期强化、无早期廓清（60秒内）以及门脉期有对比剂充盈缺损的结节被分类为LR-5。显示早期廓清、门脉期对比剂充盈缺损和/或边缘强化的结节被分类为LR-M。共评估了104例患者的104个结节（中位年龄：70.0岁；四分位间距：54.5 - 78.0岁；男性74例）。48个（46.2%）LR-5病变包括45例HCC、2例高流量血管瘤和1例肾上腺残余肿瘤。LR-5对HCC的PPV为93.8%（95%置信区间（CI）：82.8 - 98.7%）。22个（21.2%）LR-M病变包括16例非HCC恶性肿瘤和6例HCC。LR-M对包括6例肝内胆管癌在内的非HCC恶性肿瘤的PPV为100%（95% CI：69.8 - 100%）。总之，在用于Sonazoid的改良CEUS LI-RADS中，LR-5和LR-M分别是HCC和非HCC恶性肿瘤的良好预测指标。
