超声造影肝脏影像报告-数据系统与欧洲超声造影指南对肝脏结节良恶性鉴别的诊断效能对比

刘亚莉; 许国宇; 李志艳; 张倩; 栾奕; 李晓慧; 王晓蕾

doi:10.16016/j.2097-0927.202208077

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超声造影肝脏影像报告-数据系统与欧洲超声造影指南对肝脏结节良恶性鉴别的诊断效能对比

临床医学 | 更新时间：2026-01-09

- 超声造影肝脏影像报告-数据系统与欧洲超声造影指南对肝脏结节良恶性鉴别的诊断效能对比
- Diagnostic value of contrast-enhanced ultrasound liver imaging reporting and data system versus European CEUS guidelines for liver malignant tumors
- 陆军军医大学学报 2023年45卷第5期页码：462-467
- 作者机构：
  
  1.075000 河北张家口，河北北方学院研究生学院
  2.518112 广东深圳，深圳市第三人民医院放射科
  3.518112 广东深圳，深圳市第三人民医院超声科
- 作者简介：
  
  [李志艳，E-mail：lzyyuer@sina.com LI Zhiyan, E-mail: lzyyuer@sina.com
- 基金信息：
  
  国家自然科学基金面上项目(82172563)
- DOI：10.16016/j.2097-0927.202208077
  中图分类号： R730.41;R735.7
- 收稿：2022-08-12，
  
  修回：2022-09-30，
  
  纸质出版：2023-03-15
- 稿件说明：
移动端阅览
刘亚莉, 许国宇, 李志艳, 等. 超声造影肝脏影像报告-数据系统与欧洲超声造影指南对肝脏结节良恶性鉴别的诊断效能对比[J]. 陆军军医大学学报, 2023,45(5):462-467.

Yali LIU, Guoyu XU, Zhiyan LI, et al. Diagnostic value of contrast-enhanced ultrasound liver imaging reporting and data system versus European CEUS guidelines for liver malignant tumors[J]. Journal of Army Medical University, 2023, 45(5): 462-467.
刘亚莉, 许国宇, 李志艳, 等. 超声造影肝脏影像报告-数据系统与欧洲超声造影指南对肝脏结节良恶性鉴别的诊断效能对比[J]. 陆军军医大学学报, 2023,45(5):462-467. DOI： 10.16016/j.2097-0927.202208077.

Yali LIU, Guoyu XU, Zhiyan LI, et al. Diagnostic value of contrast-enhanced ultrasound liver imaging reporting and data system versus European CEUS guidelines for liver malignant tumors[J]. Journal of Army Medical University, 2023, 45(5): 462-467. DOI： 10.16016/j.2097-0927.202208077.

摘要

目的

对比超声造影肝脏影像报告-数据系统(contrast-enhanced ultrasound liver imaging reporting and data system，CEUS LI-RADS)与欧洲超声造影指南对肝细胞癌(hepatocellular carcinoma，HCC)高危人群肿瘤良恶性鉴别的诊断效能。

方法

筛选2020年8月至2022年1月在深圳市第三人民医院就诊的89例疑似HCC病例的影像学资料，其中男性74例，女性15例，年龄22~77(50.8±11.3)岁。以病理诊断为金标准，采用受试者工作曲线(receiver operating characteristic curve，ROC)分析并计算CEUS LI-RADS和欧洲CEUS指南的ROC曲线下面积(area under the subject curve，AUC)值。计算CEUS LR-5+LR-M与欧洲CEUS指南诊断肝脏恶性肿瘤的敏感性、特异性、阳性预测值、阴性预测值及准确性。

结果

92个病灶中77个病灶经CEUS归类为LR-5+LR-M，77个病灶经欧洲CEUS指南诊断为恶性肿瘤，75个病灶经病理证实为肝脏恶性肿瘤。CEUS LI-RADS和欧洲CEUS指南的AUC值分别为0.875、0.797，差异无统计学意义(

=1.71

=0.088)。以LR-5、LR-M类病灶为阳性结果，CEUS LR-5+LR-M与欧洲CEUS指南诊断肝脏恶性肿瘤的敏感性为97.3%(95%

: 90.7%~99.7%)、94.7%(95%

: 86.9%~98.5%)(χ

=8.12，

=0.004)，特异性为76.5%(95%

: 50.1%~93.2%)、64.7%(95%

: 38.3%~85.8%)，阳性预测值为94.8%、92.2%，阴性预测值为86.7%、73.3%，准确性为93.5%(95%

: 86.3%~97.6%)、89.1%(95%

: 80.9%~94.7%)(χ

=20.63，

＜0.001)。

结论

CEUS LI-RADS与欧洲CEUS指南对HCC高危人群肿瘤良恶性鉴别的诊断效能相当，CEUS LI-RADS的敏感性和准确性更高。

Abstract

Objective

To investigate the diagnostic value of contrast-enhanced ultrasound liver imaging reporting and data system (CEUS LI-RADS) and European CEUS guidelines for liver malignant tumors in high-risk patients with hepatocellular carcinoma (HCC).

Methods

The imaging data of 89 high-risk patients with suspected HCC treated in Shenzhen Third People's Hospital from August 2020 to January 2022 were retrospectively analyzed. They were 74 males and 15 females

and aged between 22 and 77 (50.8±11.3) years. Pathological diagnosis was used as the gold standard

and receiver operating characteristic (ROC) curve analysis was adopted to calculate the areas under the ROC curve (AUC) of CEUS LI-RADS and European CEUS guidlines. And the sensitivity

specificity

positive predictive value (PPV)

negative predictive value (NPV) and accuracy of CEUS LR-5+LR-M and European CEUS guidelines for diagnosing liver malignancies were calculated.

Results

Of the 92 lesions

77 lesions were classified as LR-5+LR-M by CEUS

and 77 lesions were diagnosed liver malignant tumors by European CEUS guidelines

and 75 lesions were pathologically confirmed to be malignant tumors of the liver. The AUC values of CEUS LI-RADS and European CEUS guidelines were 0.875 and 0.797

respectively

through no statistical difference (

=1.71

=0.088). Taking LR-5 and LR-M lesions as positive results

the sensitivity

specificity and PPV

NPV and accuracy were 97.3% (95%

: 90.7%~99.7%) and 94.7% (95%

: 86.9%~98.5%

Chi

-square=8.12

=0.004)

76.5% (95%

: 50.1%~93.2%) and 64.7% (95%

: 38.3%~85.8%)

94.8% and 92.2%

86.7% and 73.3%

and 93.5% (95%

: 86.3%~97.6%) and 89.1% (95%

: 80.9%~94.7%

Chi

-square=20.63

0.001) in CEUS LR-5+LR-M and European CEUS guidelines for diagnosing liver malignancies

respectively.

Conclusion

CEUS LI-RADS shows comparable diagnostic performance as European CEUS guidelines

but the sensitivity and accuracy of CEUS LI-RADS are significantly higher.

关键词

Keywords

references

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马霞, 胡向东, 谭小蕖, 等. 肝脏局灶性炎性病变的常规超声及超声造影表现[J]. 中国医学装备, 2019, 16(10): 74-77. DOI: 10.3969/J.ISSN.1672-8270.2019.10.021.

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