通讯作者: 徐琛, ccdyx77@163.com

DOI：10.12201/bmr.202601.00041

Diagnostic value of ACR CEUS LI-RADS for hepatocellular carcinoma in high-risk and non-high-risk populations

• 摘要：目的 探讨超声造影肝脏影像报告与数据系统(LI-RADS)在高危风险人群与非高危风险人群中对肝细胞癌(HCC)的诊断价值。 方法 回顾性分析538例肝内局灶性病变患者超声造影结果,参考ACR CEUS LI-RADS标准,将是否具有HCC高危因素(肝硬化、慢性乙型病毒性肝炎、HCC既往史等)分为高危风险组和非高危风险组,并对病灶进行分级,以手术或穿刺病理作为最终的结果,评价ACR CEUS LI-RADS在高危及非高危人群的诊断价值。 结果 高危风险组309例,非高危风险组229例,两组以LR-5/M类诊断恶性肿瘤灵敏度分别为90.2%、94.7%,AUC分别为0.824(95%CI：0.752~895)、0.807(95%CI：0.739~0.875)； LR-5类诊断HCC灵敏度分别为60.4%、64.7%,特异度分别为96.1%、98.6%,阳性预测值分别为93.9%、78.6%, AUC分别为0.783(95%CI：0.729~0.836)、0.816(95%CI：0.676~0.957)；LR-M类诊断肝脏其他恶性肿瘤(OM)灵敏度分别为94.0%、93.2%,AUC分别为0.850(95%CI：0.806~0.895)、0.809(95%CI：0.746~0.871)。 结论 ACR CEUS LI-RADS LR-5/M类在高危风险组和非高危风险组的应用可以初步诊断病灶良恶性,LR-5类在高危风险组诊断HCC具有较高诊断价值,LR-M类在高危风险组和非高危风险组鉴别诊断HCC与OM具有高灵敏度。

  关键词： 超声造影; 肝脏影像学报告与数据系统; 恶性; 肝细胞肝癌

   

  Abstract: Objective To evaluate the diagnostic value of the contrast-enhanced ultrasound liver imaging reporting and data system (CEUS LI-RADS) for hepatocellular carcinoma (HCC) in high-risk and non-high-risk populations. Methods Retrospectively analyzed the ultrasound contrast imaging results of 538 patients with intrahepatic focal lesions, referring to the ACR CEUS LI-RADS criteria, grouping into high-risk and non-high-risk categories based on HCC risk factors (cirrhosis, chronic HBV hepatitis, HCC history, etc.), and grading the lesions. Then assessing the diagnostic value of ACR CEUS LI – RADS in high-risk and non-high-risk populations by comparing with final surgical or biopsy pathology outcomes. Results The high-risk group comprised 309 cases, and the non-high-risk group 229. Using the LR-5/M categories for diagnosing malignant tumors, the sensitivities in diagnosing malignant tumors with LR-5/M classification were 90.2% and 94.7%, with AUC values 0.783(95%CI：0.729~0.836) and 0.807(95%CI：0.739~0.875)respectively. For LR-5 HCC diagnosis, sensitivity was 60.4% in the high-risk group and 64.7% in the non-high-risk group, specificity was 96.1% and 98.6%, positive predictive value was 93.9% and 78.6%, with AUC values 0.783 (95% CI: 0.729~0.836) and 0.816 (95%CI:0.676~0.957) respectively. For LR-M classification in diagnosing other hepatic malignancies (OM), the sensitivity was 94.0% and 93.2%, with AUC values 0.850 (95%CI:0.806~0.895) and 0.809 (95%CI:0.746~0.871) respectively. Conclusion The application of the LR-5/M categories in both high-risk and non-high-risk groups can provide an initial assessment of whether a lesion is benign or malignant. LR-5 is highly valuable for HCC diagnosis in high-risk patients. while LR-M shows high sensitivity in differentiating HCC from other malignancies across both groups.

  Key words: Contrast-enhanced ultrasound，Liver image report and data management system ，Malignant ，Hepatocellular carcinoma; ; ; 

  提交时间：2026-01-14

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• 序号	提交日期	编号	操作
  1	2026-01-07	10.12201/bmr.202601.00041V1	下载

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