摘要
目的 探讨超声造影肝脏影像报告与数据系统2017版(CEUS LI-RADS v2017)对甲胎蛋白(AFP)阴性患者肝脏局灶性病变(FLL)恶性风险的预测价值。方法 选取我院行CEUS检查的108例AFP阴性FLL患者的134个结节,其中肝细胞癌(HCC)52个,非HCC恶性肿瘤(OM)22个,良性病灶60个。采用CEUS LI-RADS v2017对结节进行分类,以组织病理学结果或增强影像学检查和临床随访结果为金标准,计算CEUS LI-RADS v2017对AFP阴性患者FLL恶性风险的预测效能;绘制受试者工作特征曲线分析其曲线下面积(AUC)。结果 LR-5与LR-4、5诊断AFP阴性HCC的敏感性、特异性分别为73.08%和88.46%、93.90%和82.93%,差异均有统计学意义(均P<0.05);AUC分别为0.84和0.86,二者比较差异无统计学意义。LR-M诊断OM的敏感性、特异性和AUC分别为90.91%、97.32%和0.94。结论 CEUS LI-RADS v2017对AFP阴性患者FLL恶性风险有一定的预测价值;其中LR-5预测HCC的特异性高而敏感性低,而LR-4、5可提高其敏感性;LR-M对OM有较好的诊断价值。
Objective To investigate the value of contrast-enhanced ultrasound liver imaging reporting and data system version 2017(CEUS LI-RADS v2017)in predicting the malignant risk of focal liver lesions(FLL)in alpha-fetoprotein(AFP)-negative patients.Methods One hundred and thirty-four lesions in 108 high-risk patients with AFP-negative who underwent CEUS in our hospital were selected,including 52 hepatocellular carcinoma(HCC),22 other malignancies(OM)and 60 benign lesions.Lesions were categorized according to the CEUS LI-RADS v2017.The histopathologicl results or enhanced imaging and follow-up were used as the golden standard,the diagnostic efficacy of CEUS LI-RADS for predicting the malignant risk of FLL in AFP-negative patients were calculated.Receiver operating characteristic(ROC)curve was drawn to analyze the area under the curve(AUC).Results The LR-5 and combination of LR-4,5 were used as criteria for the diagnosis of AFP-negative HCC,there were statistically significant differences in the sensitivity(73.08%vs.88.46%,P<0.05)and specificity(93.90%vs.82.93%,P<0.05),while no significant difference in the AUC(0.84 vs.0.86).LR-M was used as criteria for the diagnosis of OM,the sensitivity,specificity and AUC were 90.91%,97.32%and 0.94,respectively.Conclusion CEUS LI-RADS has a certain value in predicting the malignant risk of FLL in AFP-negative patients,with high specificity of LR-5 and high sensitivity of LR-4,5 in predicting AFP-negative HCC,and has a better diagnostic value of LR-M for OM.
作者
郑丽丽
冯梅晶
李军建
詹维伟
任新平
ZHENG Lili;FENG Meijing;LI Junjian;ZHAN Weiwei;REN Xinping(Department of Ultrasound,Xinrui Hospital of Xinwu District in Wuxi,Jiangsu 214028,China)
出处
《临床超声医学杂志》
CSCD
2022年第11期827-831,共5页
Journal of Clinical Ultrasound in Medicine
关键词
超声检查
造影剂
肝脏影像报告与数据系统
甲胎蛋白阴性
肝细胞癌
Ultrasonography
Contrast agent
Liver imaging reporting and data system
Alpha-fetoprotein-negative
Hepatocellular carcinoma