超声造影肝脏影像报告与数据系统对甲胎蛋白阴性肝细胞癌的诊断价值  

Contrast-Enhanced Ultrasound Liver Imaging Reporting and Data System in the Diagnosis of AFP-Negative Hepatocellular Carcinoma

作　　者：王佩华 聂芳[1] 王国娟[1] 王兰 范潇 WANG Peihua;NIE Fang;WANG Guojuan;WANG Lan;FAN Xiao(Department of Ultrasound,Lanzhou University Second Hospital,Lanzhou 730030,China)

机构地区：[1]兰州大学第二医院超声医学中心,甘肃兰州730030

出　　处：《中国医学影像学杂志》2021年第7期697-702,共6页Chinese Journal of Medical Imaging

摘　　要：目的探讨超声造影肝脏影像报告与数据系统(CEUS LI-RADS)对甲胎蛋白(AFP)阴性肝细胞癌(HCC)的诊断价值。资料与方法回顾性分析具有HCC高危风险因素、AFP阴性的肝脏局灶性病变的超声造影资料,按照CEUS LI-RADS v2017对108例患者共112个病灶进行分类,以手术病理和(或)临床诊断作为最终诊断,分析CEUS LI-RADS分类对AFP阴性HCC的诊断效能。结果112个AFP阴性病灶CEUS LI-RADS分类LR-1、LR-2、LR-3、LR-4、LR-5、LR-M类分别为3个(2.7%)、2个(1.8%)、5个(4.5%)、15个(13.4%)、70个(62.5%)、17个(15.2%)。LR-3、LR-4、LR-5、LR-M类诊断AFP阴性HCC的阳性预测值分别为20%、86.7%、98.6%、52.9%,LR-5类诊断AFP阴性HCC的阳性预测值高,但敏感度偏低(75%),若将LR-4类及以上分类作为标准进行诊断,其敏感度明显高于单独应用LR-5类(89.1%比75%),差异有统计学意义(P<0.05)。结论CEUS LI-RADS分类对AFP阴性HCC的诊断具有较高的应用价值。Purpose To evaluate the diagnostic value of contrast-enhanced ultrasound liver imaging reporting and data system(CEUS LIRADS)in patient with alpha-fetoprotein(AFP)-negative hepatocellular carcinoma(HCC).Materials and Methods A total of 112 lesions of 108 patients were classified according to CEUS LI-RADS v2017,and the CEUS data of focal hepatic lesions with HCC risk factors and negative AFP were retrospectively analyzed.Surgical pathology and/or clinical diagnosis were taken as the final golden standard diagnosis to evaluate the diagnostic value of CEUS LI-RADS classification in patient with AFP-negative HCC.Results Based on the CEUS LI-RADS classification,lesions of LR-1,LR-2,LR-3,LR-4,LR-5 and LR-M were 3(2.7%),2(1.8%),5(4.5%),15(13.4%),70(62.5%)and 17(15.2%),respectively.The positive predictive values of LR-3,LR-4,LR-5 and LR-M for AFP negative HCC were 20%,86.7%,98.6%and 52.9%,respectively.The positive predictive value of LR-5 for AFP negative HCC was the highest,with the low sensitivity(75%).However,according to the classification of LR-4 and above for the standard diagnosis,the sensitivity was significantly higher than that of LR-5 alone(89.1%vs.75%),with statistically significant difference(P<0.05).Conclusion CEUS LI-RADS classification can be with the high application value in the diagnosis and differential diagnosis in patient with AFP negative HCC.

关 键 词：癌 肝细胞 肝脏影像报告与数据系统 超声检查 造影剂 甲胎蛋白类 病理学 外科 

分 类 号：R735.7[医药卫生—肿瘤] R730.41[医药卫生—临床医学]