The role of contrast-enhanced ultrasound in the radiological classification of liver observations identified by CT and MRI

被引：0

作者：

Huang, Hui ^{[1
]}

He, Dan-Ni ^{[1
,2
]}

Lu, Rui-Fang ^{[1
]}

Tong, Wen-Juan ^{[1
]}

Wang, Ying ^{[3
]}

Qin, Si ^{[5
]}

Wen, Rong ^{[4
]}

Wu, Shao-Hong ^{[1
]}

Ruan, Si-Min ^{[1
]}

Liu, Guang-Jian ^{[5
]}

Lu, Ming-De ^{[1
]}

Kuang, Ming ^{[1
]}

Wang, Wei ^{[1
]}

Cheng, Mei-Qing ^{[1
]}

Yang, Hong ^{[4
]}

Chen, Li-Da ^{[1
]}

机构：

[1] Sun Yat Sen Univ, Inst Diag & Intervent Ultrasound, Dept Med Ultrason,Affiliated Hosp 1, Ultras Artificial Intelligence X Lab, 58 Zhongshan Rd 2, Guangzhou 510080, Peoples R China

[2] Sun Yat Sen Univ, Affiliated Hosp 7, Dept Med Ultrason, Shenzhen, Peoples R China

[3] Guangzhou Med Univ, Affiliated Hosp 1, Dept Med Ultrasound, Guangzhou, Peoples R China

[4] Guangxi Med Univ, Affiliated Hosp 1, Dept Med Ultrasound, 6 Shuangyong Rd, Nanning 530021, Guangxi, Peoples R China

[5] Sun Yat Sen Univ, Affiliated Hosp 6, Dept Med Ultrason, Guangzhou, Peoples R China

来源：

RADIOLOGIA MEDICA | 2025年 / 130卷 / 06期

基金：

中国国家自然科学基金;

关键词：

Hepatocellular carcinoma; Computed tomography; Magnetic resonance imaging; Contrast-enhanced ultrasound; Biopsy; HEPATOCELLULAR-CARCINOMA; LI-RADS; LESIONS; DIAGNOSIS;

D O I：

10.1007/s11547-025-01995-z

中图分类号：

R8 [特种医学]; R445 [影像诊断学];

学科分类号：

1002 ; 100207 ; 1009 ;

摘要：

Background & aims Timely and accurate diagnosis of hepatocellular carcinoma (HCC) is essential for improving patient outcomes and guiding treatment. This multicenter study aimed to optimize the diagnostic workflow for HCC through a step-wise combination of CT/MRI and contrast-enhanced ultrasound (CEUS) Liver Imaging Reporting and Data System (LI-RADS). Methods This was a multicenter, retrospective analysis of prospectively recruited high-risk HCC participants with liver observations from 4 institutions, between January 2017 and December 2021. These participants initially underwent CT/MRI followed by CEUS, with observations categorized according to CT/MRI/CEUS LI-RADS. Three step-wise diagnostic strategies were evaluated, starting with CT/MRI and followed by CEUS, and compared to CT/MRI LI-RADS alone. Performance metrics included AUC, accuracy, sensitivity, specificity, PPV, and NPV, using pathology or over one year of follow-up as standards. The impact on clinical decisions was measured by false-negative, false-positive, and biopsy rates. Results Of 1264 participants, 874 (69%) were confirmed as HCC. The step-wise strategies outperformed CT/MRI LI-RADS. Strategy-3, which involved subsequent CEUS for CT/MRI LR-3/4 observations, significantly improved sensitivity (88.8% vs. 79.9%, P < 0.001) while maintaining comparable specificity (88.2% vs. 91.3%, P > 0.05). Strategy-3 reduced biopsy rate (31.5-22.4%, P = 0.028) and decreased false-negative rate (20.1-11.2%, P < 0.001). Additionally, 96% (55/57) of CT/MRI LR-3 and 97% (77/79) of CT/MRI LR-4 observations were accurately diagnosed and treated as HCC, with 61% (74/121) of CT/MRI LR-4 observations avoiding biopsy with CEUS-assisted. Conclusion A step-wise approach using CT/MRI followed by CEUS for LR-3/4 observations improved the diagnostic performance and further refined clinical decision-making in HCC. Trial registration Clinical Trial Registration Number: ChiCTR-DDD-16010089.

引用

页码：805 / 816

页数：12

共 37 条

[1]

American College of Radiology, Liver Reporting & Data System 2020

[2] Increasing Health Care Burden of Chronic Liver Disease Compared With Other Chronic Diseases, 2004-2013 [J].