摘要： 目的 探讨超声造影的肝脏影像报告和数据管理系统（CEUS LI-RADS）在小肝癌诊断中的应用价值。方法 选择2008年1月至2019年12月行肝脏超声造影检查并有手术病理结果的直径≤3 cm肝脏局灶性病变病例120例。将病灶按照CEUS LI-RADS分类标准进行分类并判断其诊断效能。结果 共129个病灶，平均直径（2.2±0.5）cm，其中，LR-3类6例（4.6%），LR-4类17例（13.2%），LR-5类73例（56.5%），LR-M类33例（25.6%）。如果将LR-4类+LR-5类诊断为肝细胞癌（HCC），与单纯LR-5类诊断HCC相比较，灵敏度从64.3%提高到77.7%，差异有统计学意义（P<0.05）。如果将LR-M类早期廓清时间从1 min变为40 s，LR-4类+LR-5类诊断HCC的灵敏度更高，由77.7%提升到92.0%，差异有统计学意义（P<0.05）。LR-M类中的HCC以中低分化为主，与LR-5类相比，在分化程度上病例所占比例存在差异（P<0.05）。结论 超声造影LI-RADS分类中LR-5类和LR-4类同时作为诊断HCC的标准时，其灵敏度明显提高，LR-M类中的HCC病例以中低分化为主，应给予重视。

超声造影LI-RADS分类在小肝癌诊断中的应用价值

赵子路, 唐少珊, 彭珊珊, 陈鹏, 苏梦雪, 徐碧莹

中国医科大学附属盛京医院超声科, 沈阳 110004

收稿日期:2020-12-03出版日期:2021-07-30发布日期:2021-06-24
通讯作者:唐少珊E-mail:tangss@sj-hospital.org
作者简介:赵子路(1995-),男,硕士研究生.



关键词: 超声造影, 肝脏影像报告和数据管理系统, 肝细胞癌
Abstract: Objective To explore the clinical value of the liver imaging report and data system (LI-RADS) with contrast-enhanced ultrasound (CEUS) in the diagnosis of small hepatocellular carcinoma. Methods From January 2008 to December 2019,120 patients with focal liver lesions with diameters of ≤ 3 cm who underwent CEUS and had surgical pathological results were selected. The lesions were classified according to the CEUS LI-RADS classification to judge the diagnostic efficiency of the CEUS LI-RADS classification. Results The mean diameter of the lesions was (2.2±0.5) cm (129 lesions from 120 patients). Following the CEUS LI-RADS classification,there were 56 cases (4.6%) of LR-3,17 cases (13.2%) of LR-4,73 cases (56.5%) of LR-5,and 313 cases (25.6%) of LR-M. When the diagnosis of HCC with LR-4+LR-5 was compared with that with LR-5,the sensitivity increased significantly from 64.3% to 77.7% (P<0.05). The early clearance time of the LR-M category was changed from 1 min to 40 s. The sensitivity of LR-4+LR-5 in diagnosing HCC was higher,increasing significantly from 77.7% to 92.0% (P<0.05). The HCC in the LRM category is mainly moderately or poorly differentiated,and the proportion of cases and the degree of differentiation were significantly different between LR-M and LR-5 (P<0.05). Conclusion The sensitivity of LR-5+LR-4 in the CEUS LI-RADS classification as a diagnostic criterion for HCC can be significantly improved. The HCC in the LR-M category is mainly moderately or poorly differentiated,to which attention should be paid.
Key words: contrast-enhanced ultrasound, liver imaging report and data system, hepatocellular carcinoma
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