超声造影LI-RADS分类的应用价值  

Application value of contrast-enhanced ultrasound liver imaging reporting and data system and the correlation between background liver stiffness and its diagnostic efficacy

作　　者：许文胜[1] 赵静[2] 任颖杰 靳晓燕 刘晶晶 魏红冬 李凤 刘伟伟[1] 尚华[3] XU Wensheng;ZHAO Jing;REN Yingjie(Department of Abdominal Ultrasound,the Second Hospital of Hebei Medical University,Hebei,Shijiazhuang 050000,China;不详)

机构地区：[1]河北医科大学第二医院腹部超声科,石家庄市050000 [2]河北医科大学第二医院统计室,石家庄市050000 [3]河北医科大学第二医院核医学科,石家庄市050000 [4]河北省石家庄市人民医院

出　　处：《河北医药》2023年第15期2281-2285,共5页Hebei Medical Journal

基　　金：河北省科技厅重点研发计划项目(编号:19277774D)。

摘　　要：目的评估超声造影肝脏影像报告和数据系统(CEUS LI-RADS)在不同肝背景硬度下对HCC的诊断效能,并对不同超声医师使用该数据系统诊断结果的一致性进行分析。方法选取2019年9月至2022年9月因肝结节接受治疗的196位患者,测量其肝背景硬度,并对肝结节按CEUS LI-RADS要求进行超声造影检查,记录动态视频存档。两位超声医师对超声造影视频回放分析分别给出肝结节的LI-RADS分类,对他们判断结果的一致性进行Kappa检验。根据肝背景硬度阈值分为不同亚组,以病理结果为金标准,分别计算各亚组中根据LR-5诊断HCC的敏感性、特异性、阳性预测值、阴性预测值。结果在肝背景肝硬度阈值分别为LSM≥6.2 kPa;LSM≥7.1 kPa;LSM≥10.1 kPa和LSM≥11.7 kPa各亚组中LR-5类HCC的占比分别为97.6%、98.0%、97.6%和98.2%。以LR-5类做为诊断HCC标准,以病理结果为金标准,诊断的敏感性、特异性、阳性预测值、阴性预测值分别为95.4%、81.8%、97.6%、69.2%,各亚组均具有较高的敏感性、特异性和阳性预测值。不同超声医师使用该数据系统诊断结果的一致性非常好,Kappa值为0.88。结论CUES LI-RADS在不同肝背景硬度阈值均具有很高的诊断效能。不同超声医师使用该数据系统结果具有高度的一致性。Objective To evaluate the diagnostic efficacy of the contrast-enhanced ultrasound liveRimaging reporting and data system(CEUS LI-RADS)on hepatocellulaRcarcinoma(HCC)with varying background liveRstiffnesses,and to analyze the consistency of the diagnostic results obtained by different sonographers using the CEUS LI-RADS.Methods A total of 196 patients with liveRnodules who were treated in ouRhospital from SeptembeR2019 to SeptembeR2022 were selected.There background liveRstiffnesses were measured.The liveRnodules were examined by CEUS and classified by LI-RADS,and the video files was recorded.Two sonographers were independently responsible foRclassifying liveRnodules using the LI-RADS based on the analysis of the video files.Kappa test was performed foRidentifying the consistency of theiRresults.The sensitivity,specificity,positive predictive value(PPV)and negative predictive value(NPV)of LR-5 category foRHCC in every subgroup classified based on different stiffness threshold of background liveRwere calculated by using the pathological results as the gold standard.Results In HCC patients with the liveRstiffness measurement(LSM)≥6.2kPa,≥7.1kPa,≥10.1kPa and≥11.7kPa,the proportion of HCC with LR-5 category was 97.6%,98.0%,97.6%and 98.2%,respectively.When LR-5 was used as the cut-off value,the sensitivity,specificity,PPV and NPV in diagnosing HCC were 95.4%,81.8%,97.6%and 69.2%,respectively.All subgroups had high sensitivity,specificity and PPV.The consistency of results determined by different sonographers using the CEUS LI-RADS was high,with the Kappa value of 0.88.Conclusion CUES LI-RADS has a high diagnostic efficacy on HCC with varying LSMs.There is a high degree of consistency in the results determined by different sonographers using the CEUS LI-RADS.

关 键 词：超声造影 肝脏影像报告和数据系统 弹性成像 诊断效能 

分 类 号：R445.1[医药卫生—影像医学与核医学]