Department of Radiology, University Hospital, LMU Munich, Munich, Germany.
Department of Radiology and Nuclear Medicine, University Medical Center Mannheim, Mannheim, Germany.
Clin Hemorheol Microcirc. 2020;76(4):453-458. doi: 10.3233/CH-209221.
HCC as the 6th most common tumor entity with the fourth highest mortality and an increasing prevalence especially due to today's lifestyle acquires a high attention in the clinical setting. Beside CECT and CEMRI, CEUS depicts a dynamic, low-risk and radiation free imaging method that finds its use mainly in screening and active surveillance programs.
The aim of the retrospective study was to evaluate the diagnostic value of CEUS in correlation to pathologic findings.
Between 2004 and 2018 a total number of 119 patients were included in this retrospective single-center study. Every patient underwent CEUS in addition to a native B-mode and Color-Doppler scan. After given informed consent SonoVue® (Bracco, Milan, Italy), a second-generation blood-pool agent, was used as contrast medium. Every examination was performed and interpreted by a single experienced radiologist (EFSUMB level 3). A low mechanical index (MI) of <0,2 was chosen to obtain a good imaging quality.
All 119 included patients received CEUS followed by a liver biopsy for inter-modality comparison. In correlation to the pathology results, CEUS showed a diagnostic sensitivity of 96,6%, a specificity of 63,9%, a PPV of 86,7% and a NPV of 88,5% by detecting liver lesions suspicious for HCC. According to the Cohen's Kappa coefficient (k = 0,659) CEUS shows a strong inter-modality agreement in comparison to the histopathological finding.
With a high sensitivity and a strong cross-modality comparability to histopathology, the CEUS is highly effective in the detection of suspicious HCC lesions.
肝癌是第六大常见肿瘤实体，死亡率居第四位，且由于当今的生活方式，其发病率呈上升趋势，因此在临床环境中受到高度关注。除了 CECT 和 CEMRI 外，CEUS 还提供了一种动态、低风险且无辐射的成像方法，主要用于筛查和主动监测计划。
本回顾性研究旨在评估 CEUS 的诊断价值，并将其与病理发现相关联。
在 2004 年至 2018 年间，共有 119 名患者纳入本回顾性单中心研究。每位患者均接受了 CEUS 检查，同时还进行了原始 B 型和彩色多普勒扫描。在获得知情同意后，使用 SonoVue®（Bracco，米兰，意大利）作为第二代血池造影剂。每次检查均由一位经验丰富的放射科医生（EFSUMB 3 级）进行操作和解释。选择低机械指数（MI）<0.2 以获得良好的成像质量。
所有 119 名纳入患者均接受了 CEUS 检查，随后进行了肝活检以进行模态间比较。与病理结果相关联，CEUS 检测疑似 HCC 的肝脏病变的诊断灵敏度为 96.6%，特异性为 63.9%，阳性预测值为 86.7%，阴性预测值为 88.5%。根据 Cohen 的 Kappa 系数（k=0.659），CEUS 与组织病理学发现相比具有较强的模态间一致性。
CEUS 具有较高的灵敏度和与组织病理学较强的跨模态可比性，在检测可疑 HCC 病变方面非常有效。
