结合CT/MRILI-RADS与二线对比增强超声波使用硫化或黄用于诊断高风险患者肝细胞癌的第二线对比增强超声波
1Department of Ultrasound, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Provincial Clinical Research Center for Cancer, Guangzhou, China.
Korean journal of radiology
|February 27, 2025
概括
结合CT/MRILI-RADS与使用硫化或黄素的对比度增强超声波 (CEUS) LI-RADS,可显著改善高风险患者肝细胞癌 (HCC) 检测灵敏度. 这种方法可以提高诊断的准确性,而不会牺牲特异性.
科学领域:
- 放射学和成像学 放射学和成像学
- 肝病学 肝病学是一种肝病学.
- 在瘤学瘤学.
背景情况:
- 计算机断层扫描/磁共振成像 (CT/MRI) 肝脏成像报告和数据系统 (LI-RADS) 提供高特异性,但在高风险人群中诊断肝细胞癌 (HCC) 的敏感性有限.
- 提高HCC检测灵敏度对于及时启动治疗和改善患者治疗结果至关重要.
研究的目的:
- 为了评估CT/MRILI-RADS与二线对比增强超声波 (CEUS) LI-RADS使用硫六化物 (SHF) 或 perfluorobutane (PFB) 增强HCC诊断灵敏度的有效性.
- 评估这种综合方法是否能够保持CT/MRILI-RADS的高特异性.
主要方法:
- 对从高风险患者获得的前性收集的多中心数据的回顾性分析.
- 同时进行CT/MRI,SHF增强的US和PFB增强的US检查.
- 对单独CT/MRILI-RADS和三个组合策略进行了对比:CT/MRILI-RADS与LI-RADS SHF,LI-RADS PFB或修改的PFB算法.
主要成果:
- 该研究包括281名参与者,306例肝脏观察 (227例HCC).
- 组合策略将20-31个CT/MRILR-3/4观测重新分类为LR-5,所有这些都被确认为HCC.
- 敏感度从单独CT/MRILI-RADS的74%增加到组合策略的83%-88% (P<0.001),而特异性仍然高,为92%.
结论:
- 将CT/MRI LI-RADS与二线CEUS (SHF或PFB) 结合起来,可显著提高高风险患者诊断HCC的敏感性.
- 这种综合成像方法成功地提高了HCC检测率,而不会影响诊断特异性.
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