Diagnostic Accuracy of CEUS LI-RADS for the Characterization of Liver Nodules 20 mm or Smaller in Patients at Risk for Hepatocellular Carcinoma
Diagnostic Accuracy of CEUS LI-RADS for the Characterization of Liver Nodules 20 mm or Smaller in Patients at Risk for Hepatocellular Carcinoma
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CEUS LI-RADS 对肝细胞癌风险患者中 20 毫米或更小的肝结节特征的诊断准确性
DOI：
10.1148/radiol.2019191086
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发表时间：
2020-02-01
期刊：
影响因子：
19.7
通讯作者：
Lyshchik, Andrej
中科院分区：
文献类型：
--
作者：
Huang, Jia-Yan;Li, Jia-Wu;Lyshchik, Andrej
工作背景：美国放射学会造影剂增强的美国肝脏成像报告和数据系统（CEUS LI-RADS）的开发旨在提高造影剂增强超声诊断肝细胞癌（HCC）的准确性。然而，据作者所知，该系统在表征20 mm或更小的肝结节中的诊断准确性尚未得到充分评价。目的：评价CEUS LI-RADS在诊断HCC风险患者中20 mm或更小的肝结节中HCC的诊断准确性。材料和方法：在2015年1月至2018年2月期间，有HCC风险的连续患者因未经治疗的20 mm或更小的肝结节而入组这项回顾性双读研究。根据CEUS LI-RADS和世界医学和生物学超声联合会（WFUMB）-欧洲医学和生物学超声学会联合会（EFSUMB）标准对每个结节进行分类。以组织病理学分析、多期增强CT和MRI、影像学随访作为参考标准，采用McNemar检验比较CEUS LI-RADS和WFUMB-EFSUMB定性诊断性能（平均直径，16.1 mm +/- 3.4）（平均年龄，51.8岁+/- 10.6; 136名男性）。CEUS LR-5与WFUMB-EFSUMB标准诊断HCC的敏感性分别为73.3%（95%CI：63.8%，81.5%）与88.6%（95%CI：80.9%，94%）（P
Background: American College of Radiology contrast agent-enhanced US Liver Imaging Reporting and Data System (CEUS LI-RADS)was developed to improve the accuracy of hepatocellular carcinoma (HCC) diagnosis at contrast agent-enhanced US. However, to the knowledge of the authors, the diagnostic accuracy of the system in characterization of liver nodules 20 mm or smaller has not been fully evaluated.Purpose: To evaluate the diagnostic accuracy of CEUS LI-RADS in diagnosing HCC in liver nodules 20 mm or smaller in patients at risk for HCC.Materials and Methods: Between January 2015 and February 2018, consecutive patients at risk for HCC presenting with untreated liver nodules 20 mm or less were enrolled in this retrospective double-reader study. Each nodule was categorized according to the CEUS LI-RADS and World Federation for Ultrasound in Medicine and Biology (WFUMB)-European Federation of Societies for Ultrasound in Medicine and Biology (EFSUMB) criteria. Diagnostic performance of CEUS LI-RADS and WFUMB-EFSUMB characterization was evaluated by using tissue histologic analysis, multiphase contrast-enhanced CT and MRI, and imaging followup-as reference standard and compared by using McNemar test.Results: The study included 175 nodules (mean diameter, 16.1 mm +/- 3.4) in 172 patients (mean age, 51.8 years +/- 10.6; 136 men). The sensitivity of CEUS LR-5 versus WFUMB-EFSUMB criteria in diagnosing HCC was 73.3% (95% confidence interval[CI]: 63.8%, 81.5%) versus 88.6% (95% CI: 80.9%, 94%), respectively (P