Wang Peihua, Nie Fang, Dong Tiantian, Yang Dan, Liu Ting, Wang Guojuan
Medical Center of Ultrasound, Lanzhou University Second Hospital, Lanzhou 730030, China.
Diagnostics (Basel). 2021 Dec 1;11(12):2250. doi: 10.3390/diagnostics11122250.
To explore the diagnostic value of Contrast-enhanced Ultrasound Liver Imaging Reporting and Data System version 2017 (CEUS LI-RADS v2017) in differentiating alpha-fetoprotein (AFP)-negative hepatocellular carcinoma (HCC) from other primary malignancies (OM) of the liver.
The data of 99 patients with primary liver malignant tumors confirmed by surgical pathology and AFP-negative from January 2018 to January 2021 were retrospectively analyzed, and the lesions were divided into 61 cases in the AFP-negative HCC group and 38 cases in the OM group according to the pathological findings, the CEUS features of the lesions were analyzed and the lesions were classified according to the CEUS LI-RADS v2017. Comparison of CEUS features between the two groups was performed using the χ test. The sensitivity, specificity, positive predictive value, negative predictive value, and coincidence rate of CEUS LI-RADS v2017 for the diagnosis of AFP-negative HCC and OM were calculated using pathological findings as the gold standard.
The differences in features of arterial phase enhancement and wash-out between the HCC and OM groups were statistically significant ( < 0.05). The sensitivity of diagnosing HCC by LR-5 was 62.3% and the specificity was 92.1%. The sensitivity of diagnosing OM by LR-M was 92.1% and the specificity was 83.6%.
When AFP is negative in patients with intrahepatic focal lesions, LR-5 has high specificity but low sensitivity in the diagnosis of HCC, and LR-M has high sensitivity and specificity in the diagnosis of OM. CEUS LI-RADS is a tool to differentiate AFP-negative HCC and OM effectively.
探讨2017版超声造影肝脏影像报告和数据系统（CEUS LI-RADS v2017）在鉴别甲胎蛋白（AFP）阴性的肝细胞癌（HCC）与肝脏其他原发性恶性肿瘤（OM）中的诊断价值。
回顾性分析2018年1月至2021年1月99例经手术病理确诊且AFP阴性的原发性肝脏恶性肿瘤患者的数据，根据病理结果将病灶分为AFP阴性HCC组61例和OM组38例，分析病灶的CEUS特征并依据CEUS LI-RADS v2017对病灶进行分类。两组间CEUS特征比较采用χ检验。以病理结果为金标准，计算CEUS LI-RADS v2017诊断AFP阴性HCC和OM的灵敏度、特异度、阳性预测值、阴性预测值及符合率。
HCC组与OM组在动脉期强化和廓清特征方面的差异具有统计学意义（<0.05）。LR-5诊断HCC的灵敏度为62.3%，特异度为92.1%。LR-M诊断OM的灵敏度为92.1%，特异度为83.6%。
肝内局灶性病变患者AFP阴性时，LR-5诊断HCC具有高特异度但低灵敏度，LR-M诊断OM具有高灵敏度和特异度。CEUS LI-RADS是有效鉴别AFP阴性HCC和OM的工具。
