Contrast-enhanced Ultrasound(CEUS)liver Imaging Reporting And Data System(LI-RADS)LR-5 For Hepatocellular Carcinoma–diagnostic Value In Clinical Practice

Purpose:The aim of this retrospective study was to assess the diagnostic value of liver imaging reporting and data system(LI-RADS)LR-5 type for hepatocellular carcinoma by contrast-enhanced ultrasound(CEUS),compared to the CT/MRI LI-RADS system.Material and method:A retrospective analysis was performed on 241 patients with liver focal lesion who received contrast-enhanced ultrasonography in department of abdominal ultrasound of our hospital from January 2017 to December 2018.The lesion location,echo,size,enhancement degree and pattern of arterial phase,washout time were recorded by reviewing the video.According to the CEUS LI-RADS scheme criteria,two physicians independently classified all the lesion and calculated the sensitivity,specificity,accuracy,Youden's index,likelihood ratio,positive predictive value,negative predictive value and the area under the ROC curve for the diagnosis of hepatocellular carcinoma at LR-5 type.To compare the difference between CEUS and CT/MRI in the diagnosis of hepatocellular carcinoma.Results:According to the inclusion and exclusion criteria,241 patients and 272 lesions were finally enrolled.Among them,160 lesions were diagnosed by histopathology and 112 lesions were definitely diagnosed clinically.All pathologically diagnosed lesions showed enhanced CT/MRI findings.The positive predicted value of CEUS LR-5 type for hepatocellular carcinoma diagnosed was 97%,the sensitivity was 81%,the specificity was 93.1% and the area under the ROC curve was 0.8703.Intrahepatic cholangiocarcinoma lesions were all assigned to the LR-M type and were not misdiagnosed as hepatocellular carcinoma.The positive predicted value of CT/MRI LR-5 type for hepatocellular carcinoma diagnosed was 95%,the sensitivity was 83.9%,the specificity was 94% and the area under the ROC curve was 0.8895.Conclusion:LI-RADS scheme provides a reference standard for the standardized evaluation and report of contrast-enhanced ultrasonography.LR-5 type has good efficacy in the diagnosis of hepatocellular carcinoma,which can avoid the possibility of the misdiagnosis of intrahepatic cholangiocarcinoma as hepatocellular carcinoma.CEUS can achieve the same diagnostic efficacy as enhanced CT/MRI.CEUS is an ideal method for the diagnosis of hepatocellular carcinoma.