Feasibility study of contrast-enhanced ultrasound LI-RADS in the diagnosis of primary hepatocellular carcinoma

Abstract

Abstract: Objective To study the feasibility of contrast-enhanced ultrasound (CEUS) liver imaging reporting and data system (LI-RADS) in the diagnosis of primary hepatocellular carcinoma. Methods Clinical data of high-risk patients with primary hepatocellular carcinoma admitted to our department from June 2016 to June 2019 were collected. The diagnosis of the disease was in accordance with the 2015 edition of practice guidelines for pathological diagnosis of primary liver cancer. The ultrasound contrast agent is SonoVue (Bracco Company, Italy). The 2017 edition of CEUS LI-RADS was adopted. In this study, pathological results were used as the diagnostic gold standard. LI-RADS class 1 (LR-1) and LI-RADS class 2 (LR-2) were defined as negative results, LI-RADS 3 (LR-3), LI-RADS 4 (LR-4) and LI-RADS 5 (LR-5) as positive ones. The diagnostic value was analyzed by receiver operator characteristic (ROC) curve. Results There were 74 patients enrolled in the study, including 52 males and 22 females, with an average age of (54.2 ± 11.4) years. A total of 86 lesions were detected. The diameter of the lesions ranged from 0.6 to 9.2 cm, with an average of (2.6 ± 1.4) cm. The pathological results included primary hepatocellular carcinoma (72), cholangiocarcinoma (3), focal nodular hyperplasia (6), hepatic hemangioma (3) and inflammatory lesions (2). Based on CEUS LI-RADS, there were 4 cases of LR-1, 5 cases of LR-2, 16 cases of LR-3, 25 cases of LR-4 and 36 cases of LR-5. The area under the ROC curve was 0.86 (95% confidence interval: 0.80-0.91). The diagnostic indexes of CEUS LI-RADS for primary hepatocellular carcinoma were as follows: the accuracy of 94.2% (81/86), the sensitivity of 100% (72/72), the specificity of 64.3% (9/14), the positive predictive value of 91.1% (72/79), and the negative predictive value of 100% (9/9). When LR-3 was not taken into account, the adjusted diagnostic indexes were as follows: the accuracy of 97.1% (68/70), the sensitivity of 100% (59/59), the specificity of 81.8% (9/11), the positive predictive value of 96.7% (59/61), and the negative predictive value of 100% (9/9). Conclusion CEUS LI-RADS performs well in the diagnosis of primary hepatocellular carcinoma, which has clinical feasibility.

Key words: Primary hepatocellular carcinoma, Liver imaging reporting and data system, Contrast-enhanced ultrasound

LI Ming-hui TANG Rong CHEN Sun-bin. Feasibility study of contrast-enhanced ultrasound LI-RADS in the diagnosis of primary hepatocellular carcinoma[J]. Chinese Hepatolgy, 2020, 25(8): 822-824.

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