Department of Medical Ultrasound, The First Affiliated Hospital of Guangxi Medical University, Nanning, China.
J Ultrasound Med. 2023 Oct;42(10):2403-2413. doi: 10.1002/jum.16267. Epub 2023 Jun 3.
To assess the diagnostic performance of the contrast-enhanced ultrasound liver imaging reporting and data system (CEUS LI-RADS) version 2017 for small hepatic lesions of ≤3 cm before and after changing the LR-M criteria.
We retrospectively analyzed the CEUS examination of 179 patients who were at high risk of hepatocellular carcinoma (HCC) with focal hepatic lesions ≤3 cm (194 lesions in total) and evaluated the diagnostic capability of the American College of Radiology and modified CEUS LI-RADS algorithms.
Revision of the early washout time to 45 seconds increased the sensitivity of LR-5 in predicting HCC (P = .004), with no significant decrease in specificity (P = .118). It also made better the specificity of LR-M in predicting non-HCC malignancies (P = .001), with no significant decrease in sensitivity (P = .094). However, using within 3 minutes as the criterion for marked washout time improved the LR-5 sensitivity (P < .001) but decreased its specificity (P = .009) in predicting HCC, whereas the specificity of LR-M in predicting non-HCC malignancies increased (P < .001), but the sensitivity decreased (P = .027).
CEUS LI-RADS (v2017) is a valid method for predicting HCC risk in high-risk patients. The diagnostic performance of LR-5 and LR-M could boost when the early washout time is revised to 45 seconds.
评估对比增强超声肝脏成像报告和数据系统（CEUS LI-RADS）版本 2017 在改变 LR-M 标准前后对≤3cm 小肝病变的诊断性能。
我们回顾性分析了 179 例高危肝癌（HCC）患者的 CEUS 检查结果，这些患者的局灶性肝病变≤3cm（共 194 个病变），并评估了美国放射学院和改良 CEUS LI-RADS 算法的诊断能力。
将早期洗脱时间修订为 45 秒增加了 LR-5 预测 HCC 的敏感性（P=0.004），而特异性无显著下降（P=0.118）。这也使 LR-M 预测非 HCC 恶性肿瘤的特异性更好（P=0.001），而敏感性无显著下降（P=0.094）。然而，使用 3 分钟内作为明显洗脱时间的标准提高了 LR-5 预测 HCC 的敏感性（P<0.001），但降低了其特异性（P=0.009），而 LR-M 预测非 HCC 恶性肿瘤的特异性增加（P<0.001），但敏感性下降（P=0.027）。
CEUS LI-RADS（v2017）是预测高危患者 HCC 风险的有效方法。将早期洗脱时间修订为 45 秒可提高 LR-5 和 LR-M 的诊断性能。
