The application value of liver imaging-reporting and data system (LI-RADS) of contrast-enhanced ultrasound in LR-3, LR-4 and LR-5 lesions

Abstract

Abstract: Objective To explore the application value of liver imaging-reporting and data system (LI-RADS) of contrast-enhanced ultrasound (CEUS) in LR-3, LR-4 and LR-5 lesions. Methods From January 2013 to January 2019, 122 patients including 87 males and 35 females with liver focal lesions at risk of hepatocellular carcinoma (HCC) were collected, with an average age of 53.1±8.4 years. The diagnostic performance of CEUS LI-RADS classification was evaluated, with liver pathology as the diagnostic gold standard. The comparison of measurement data (x+s) were performed with t test, and the comparison of counting data (%) were analyzed with chi-square test. Results There were 146 lesions in these patients, of which 120 (82.2%) were pathologically confirmed HCC and 26 (17.8%) were benign liver lesions. 5 were classified as LR-1, 3 were LR-2, all were benign;16 were classified as LR-3, 32 were LR-4 and 90 were LR-5. The LR-1, LR-2 lesions were considered as negative, whereas the LR-3, LR-4 and LR-5 lesions were positive. The sensitivity, specificity and accuracy of LR-3+LR-4+LR-5 in the diagnosis of HCC were 95.8%, 30.8% and 84.2%. Regardless of LR-3 lesions, the sensitivity, specificity and accuracy of LR-4+LR-5 in the diagnosis of HCC were 100%, 53.3% and 94.6%,. Regardless of LR-3 and LR-4 lesions, the sensitivity, specificity and accuracy of LR-5 in the diagnosis of HCC were 100%, 80.0% and 98.0%. The specificity of LR-3+LR-4+LR-5 (30.8%) in the diagnosis of HCC was significantly lower than that of LR-4+LR-5 (53.3%, P<0.05) and LR-5 (80.0%, P<0.05). Meanwhile, the specificity of LR-4+LR-5 (53.3%) was significantly lower than LR-5 (80.0%, P<0.05). The diagnostic accuracy of LR-3+LR-4+LR-5 (84.2%) was significantly lower than that of LR-4+LR-5 (94.6%, P<0.05) and LR-5 (98.0%, P<0.05). However, there was no significant difference in the diagnostic sensitivity between LR-3+LR-4+LR-5, LR-4+LR-5 and LR-5 (P>0.05). Conclusion CEUS LI-RADS classification standard has high diagnostic accuracy for LR-3, LR-4, LR-5 HCC lesions, especially for LR-5 lesions.

Key words: Contrast-enhanced ultrasonography, Hepatocellular carcinoma, Liver imaging-reporting and data system

YANG Da-cai, WU Hong, ZHU Ting-ling. The application value of liver imaging-reporting and data system (LI-RADS) of contrast-enhanced ultrasound in LR-3, LR-4 and LR-5 lesions[J]. Chinese Hepatolgy, 2020, 25(8): 816-818.

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