静脉肿瘤起源的鉴别：LI-RADS v2017 与 v2016 对比在高危患者中的应用。
Identification of the origin of tumor in vein: comparison between CEUS LI-RADS v2017 and v2016 for patients at high risk.
机构信息
Department of Medical Ultrasonics, Institute of Diagnostic and Interventional Ultrasound, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, People's Republic of China.
Department of Medical Ultrasound, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, People's Republic of China.
出版信息
BMC Med Imaging. 2022 Oct 29;22(1):186. doi: 10.1186/s12880-022-00912-4.
OBJECTIVES
To compare the diagnostic performance of the Contrast-Enhanced Ultrasound (CEUS) Liver Imaging Report and Data System (LI-RADS) v2016 and v2017 in identifying the origin of tumor in vein (TIV).
METHODS
From April 2014 to December 2018, focal liver lesions (FLLs) accompanied by TIV formation in patients at high risk for hepatocellular carcinoma (HCC) were enrolled. Histologic evaluation or composite imaging reference standard were served as the reference standard. Each case was categorized according to the CEUS LI-RADS v2016 and v2017, respectively. Diagnostic performance of CEUS LI-RADS v2016 and v2017 in identifying the originated tumor of TIV was validated via sensitivity, specificity, accuracy, positive predictive value (PPV) and negative predictive value.
RESULTS
A total of 273 FLLs with TIV were analyzed finally, including 266 HCCs and 7 non-HCCs. In v2016, when adopting all TIV as LR-5V, the accuracy and PPV in identifying the originated tumor were both 97.4%. In v2017, when assigning TIV according to contiguous FLLs CEUS LI-RADS category, the accuracy and PPV were 61.9% and 99.4% in subclass of LR-5 as the diagnostic criteria of HCC, and 64.1% and 99.4% in subclass of LR-4/5 as the criteria of HCC diagnosis. There were significant differences in diagnostic accuracy between CEUS LI-RADS v2016 and v2017 in identifying the originated tumor of TIV (p < 0.001).
CONCLUSIONS
CEUS LI-RADS v2016 could be better than v2017 in identifying the originated tumor of TIV.
目的
比较对比增强超声（CEUS）肝脏成像报告和数据系统（LI-RADS）v2016 与 v2017 诊断肿瘤静脉起源（TIV）的性能。
方法
本研究纳入 2014 年 4 月至 2018 年 12 月期间在高危人群中接受治疗的伴有 TIV 形成的局灶性肝脏病变（FLL）患者。组织学评估或综合成像参考标准作为参考标准。根据 CEUS LI-RADS v2016 和 v2017 将每个病例分别进行分类。通过敏感性、特异性、准确性、阳性预测值（PPV）和阴性预测值验证 CEUS LI-RADS v2016 和 v2017 识别 TIV 起源肿瘤的诊断性能。
结果
最终分析了 273 个伴有 TIV 的 FLL，其中包括 266 个 HCC 和 7 个非 HCC。在 v2016 中，当将所有 TIV 归类为 LR-5V 时，识别起源肿瘤的准确性和 PPV 均为 97.4%。在 v2017 中，当根据连续 FLL 的 CEUS LI-RADS 类别分配 TIV 时，LR-5 亚类作为 HCC 诊断标准的准确性和 PPV 分别为 61.9%和 99.4%，LR-4/5 亚类作为 HCC 诊断标准的准确性和 PPV 分别为 64.1%和 99.4%。CEUS LI-RADS v2016 和 v2017 识别 TIV 起源肿瘤的诊断准确性有显著差异（p<0.001）。
结论
CEUS LI-RADS v2016 可能比 v2017 更能识别 TIV 的起源肿瘤。
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