Department of Ultrasound, Sichuan University West China Hospital, Chengdu, China.
Ultraschall Med. 2021 Apr;42(2):187-193. doi: 10.1055/a-1309-1568. Epub 2020 Dec 11.
The American College of Radiology (ACR) contrast-enhanced ultrasound liver imaging reporting and data system (CEUS LI-RADS), which includes diagnostic criteria for hepatocellular carcinoma (HCC) and other hepatic malignancies (OM), is increasingly used in clinical practice. This study performed a meta-analysis to assess the diagnostic accuracy of CEUS LI-RADS for differentiating between HCC and OM in high-risk patients.
PubMed, Embase (Ovid), and Cochrane (CENTRAL) were searched for relevant studies. All studies that reported the percentage of HCC and OM in the LI-RADS categories were included. Random-effects models were used to calculate the pooled sensitivity and specificity, diagnostic odds ratio (DOR), and summary receiver operating characteristic (SROC) curve.
Eight studies involving 4215 focal liver lesions were included in the final analysis. The pooled sensitivity and specificity of the LR-5 criteria for HCC were 0.71 (95 % CI, 0.69-0.72) and 0.88 (0.85-0.91), respectively, the DOR was 18.36 (7.41-45.52), and the area under the SROC curve (AUC) was 0.8128. The pooled sensitivity and specificity of the LR-M criteria for OMs were 0.85 (0.81-0.88) and 0.86 (0.85-0.87), the DOR was 27.82 (11.83-65.40), respectively, and the SROC AUC was 0.9098.
The CEUS LI-RADS can effectively distinguish HCC from other hepatic malignancy in high-risk patients based on LR-5 criteria and LR-M criteria. However, further studies are needed for validation due to the limited number of included studies and the potential heterogeneity among the included studies.
美国放射学院（ACR）的对比增强超声肝脏成像报告和数据系统（CEUS LI-RADS），其中包括肝细胞癌（HCC）和其他肝脏恶性肿瘤（OM）的诊断标准，在临床实践中越来越多地被使用。本研究进行了一项荟萃分析，以评估 CEUS LI-RADS 在区分高危患者的 HCC 和 OM 方面的诊断准确性。
检索了 PubMed、Embase（Ovid）和 Cochrane（CENTRAL）数据库，以寻找相关研究。所有报告 LI-RADS 分类中 HCC 和 OM 百分比的研究均被纳入。使用随机效应模型计算汇总敏感性和特异性、诊断优势比（DOR）和汇总受试者工作特征（SROC）曲线。
最终分析纳入了 8 项涉及 4215 个局灶性肝病变的研究。LR-5 标准对 HCC 的汇总敏感性和特异性分别为 0.71（95%CI，0.69-0.72）和 0.88（0.85-0.91），DOR 为 18.36（7.41-45.52），SROC 曲线下面积（AUC）为 0.8128。LR-M 标准对 OM 的汇总敏感性和特异性分别为 0.85（0.81-0.88）和 0.86（0.85-0.87），DOR 为 27.82（11.83-65.40），SROC AUC 为 0.9098。
CEUS LI-RADS 可以根据 LR-5 标准和 LR-M 标准有效地在高危患者中区分 HCC 和其他肝脏恶性肿瘤。然而，由于纳入研究的数量有限，以及纳入研究之间可能存在的异质性，还需要进一步的研究来验证。
