摘要
目的探讨超声造影诊断肝硬化背景肝脏影像报告与数据系统(LI-RADS)3类对肝硬化背景肝癌阳性率的诊断价值。方法回顾性分析2016年4月~2019年5月于浙江中医药大学附属杭州西溪医院就诊的乙型肝炎肝硬化患者,且根据2017版超声造影LI-RADS分类标准诊断为LI-RADS 3类的超声造影表现资料,共252例患者,261个病灶,患者均能获得满意的病理组织,将超声造影结果与病理结果进行对比。结果261个病灶,最大直径平均1.5 cm,病理证实良性病灶243个,HCC 18个,造影模式中主要以快进等出及等进等出为主,快进等出85个病灶,等进等出179个病灶,LI-RADS 3类中HCC总体阳性预测值为6.9%,且均在快进等出增强模式中,快进等出模式中HCC阳性预测值为21.2%。结论超声造影LI-RADS 3类肝内结节病理结果多样,主要为增生结节及不典型增生结节,LI-RADS 3类中HCC的增强模式主要是快进等出模式,为以后超声造影LI-RADS 3类的肝脏结节性质诊断,尤其HCC的诊断提供了指导意义。
Objective To diagnostic value of contrast-enhanced ultrasonography(CEUS)of LI-RADS category 3 in the positive rate of hepatocellular carcinoma under the background of liver cirrhosis.Methods The manifestation data of 252 patients with 261 lesions who had hepatitis B cirrhosis and were admitted to our hospital from April 2016 to May 2019 were retrospectively analyzed.Their lesions were classified as LI-RADS category 3 according to the 2017 edition of classification criteria for CEUS LI-RADS.Satisfactory pathological tissues were obtained from patients.Contrast-enhanced ultrasonography results were compared with pathological results.Results The average maximum diameter of 261 lesions was 1.5 centimeters,and 243 benign lesions and 18 HCC lesions were confirmed by pathology.The imaging model was dominated by fast-in-equal-out(85 lesions)and equal-in-equal-out(179 lesions).The overall positive predictive value of HCC in LI-RADS category 3 was 6.9%,and all of them were in the enhancement mode of fast-in-equal-out.The positive predictive value of HCC in the fast-in-equal-out mode was 21.2%.Conclusion The pathological results of LI-RADS category 3 of intrahepatic nodules vary,mainly for hyperplastic nodules and atypical hyperplastic nodules.The enhancement mode of HCC in LI-RADS category 3 is mainly the fast-in-equal-out mode,which provides guidance for the future diagnosis of liver nodules in CEUS of LI-RADS category 3,especially for the diagnosis of HCC.
作者
曹南
蔡怀杰
孙希希
刘德林
包剑锋
黄斌
CAO Nan;CAI Huaijie;SUN Xixi;LIU Delin;BAO Jianfeng;HUANG Bin(Department of Liver Disease,Hangzhou Xixi Hospital Affiliated to Zhejiang University of Traditional Chinese Medicine,Hangzhou310023,China;Department of Ultrasonography,Hangzhou Xixi Hospital Affiliated to Zhejiang University of Traditional Chinese Medicine,Hangzhou310023,China)
出处
《中国现代医生》
2019年第35期103-105,I0002,共4页
China Modern Doctor
基金
浙江省医药卫生科技计划项目（2019KY532）
关键词
超声造影
LI-RADS
3类
HCC
乙肝肝硬化
Contrast-enhanced ultrasonography(CEUS)
LI-RADS category 3
HCC
Hepatitis B cirrhosis
