DN-HCC及DN患者超声造影及CEUS LI-RADS标准分类结果观察

Contrast ultrasonography and CEUS LI-RADS standard classification of DN-HCC and DN patients were observed

目的 探讨异型增生结节伴局灶性肝细胞癌(DN-HCC)及异型增生结节(DN)患者超声造影(CEUS)表现及CEUS肝脏影像报告和数据系统(CEUS LI-RADS)标准分类结果。方法 2019年10月至2021年10月北京市大兴区人民医院收治的肝脏局灶性病变患者78例(80个病灶,其中DN 12个,DN-HCC 68个),接受CEUS检查。根据CEUS LI-RADS v2017标准,对所有病灶进行分类。结果 DN组动脉期同步等增强占比为66.7%,显著高于DN-HCC组的13.2%(P<0.05);DN组动脉期高增强占比为16.7%,显著低于DN-HCC组的58.8%(P<0.05)。DN组病灶动脉期和延迟期CEUS增强模式有三种,低/等占25.0%,等/等占66.7%,高/高占8.3%;DN-HCC组CEUS增强模式包括六种,其中等/等占4.4%,低/低占5.9%,等/低占8.8%,低/等占13.2%,高(含局部高增强)/低占29.4%,高(含局部高增强)/等占38.2%。DN组CEUS LI-RADS v2017标准分类中LR-3类占比为100.0%,高于DN-HCC组的26.5%(P<0.05)。结论 CEUS动脉期高增强或延迟期减退对DN与DN-HCC具有鉴别意义,值得临床验证。

Objective To investigate the contrast-enhanced ultrasound(CEUS) findings and the standard classification results of CEUS liver image reporting and data system(CEUS LI-RADS) in patients with dysplastic nodules with focal hepatocellular carcinoma(DN-HCC) and dysplastic nodules(DN). Methods 78 patients with hepatic focal lesions(80 lesions, including 12 DN and 68 DN-HCC) admitted to our hospital between October 2019 and October 2021, and all patients underwent CEUS examination. All lesions were classified according to CEUS Li-RADS V2017 criteria. Results The proportion of synchronous enhancement in arterial phase in DN group was 66.7%, which was significantly higher than 13.2% in DN-HCC group(P<0.05);The proportion of high enhancement in arterial phase in DN group was 16.7%, which was significantly lower than 58.8% in DN-HCC group(P<0.05). In the DN group, there were three CEUS enhancement modes in arterial phase and delayed phase, of which low/equal accounted for 25.0%, equal/equal accounted for 66.7%, and high/high accounted for 8.3%;There were six CEUS enhancement modes in dn-hcc group, of which equal/equal accounted for 4.4%, low/low accounted for 5.9%, equal/low accounted for 8.8%, low/equal accounted for 13.2%, high(including local high enhancement)/low accounted for 29.4%, and high(including local high enhancement)/equal accounted for 38.2%. The proportion of LR-3 in CEUS LI-RADS v2017 standard classification in DN group was 100.0%, which was higher than 26.5% in DN-HCC group(P<0.05). Conclusion CEUS arterial phase high enhancement or delayed phase decline has differential significance between DN and DN-HCC, which is worthy of clinical verification.