LI-RADS超声分类诊断肝脏占位性病变准确性分析

目的 探讨应用LI-RADS超声分类方法诊断肝脏占位性病变的准确性。方法 2018年1月～2019年9月我院经病理学检查诊断为肝脏占位性病变患者60例,均接受超声造影检查。按照LI-RADS分类方法,分别以LR-3(方法1)和LR-4a(方法2)作为为截断点,分析两种方法鉴别良恶性病变的效能。结果 在60例肝占位性病变患者中,综合诊断肝囊肿4例,肝血管瘤16例,肝脓肿8例,肝局灶性脂肪变9例,肝局灶性结节性增生9例,肝细胞癌8例,肝转移瘤6例;以病理学检查诊断为金标准,方法1诊断恶性病变22例,良性病变38例。方法 2诊断恶性病变14例,良性病变46例;方法1诊断的灵敏度、特异度和正确率分别为85.7%、78.2%和80.0%,而方法2则分别为78.6%、93.5%(P<0.05)和100.0%(P<0.05)。结论 采用LI-RADS 方法2分辨肝脏占位性病变的性质具有很高的准确性,其临床应用价值值得进一步研究。

Diagnostic accuracy ofcontrast enhanced ultrasound by LI-RADS in patients with space-occupying liver lesions

Objective The aim of this study was to explore the diagnostic accuracy of contrast enhanced ultrasound (CEUS) by liver imaging report and data system (LI-RADS) in patients with space-occupying liver lesions. Methods 60 patients were clinically confirmed with space-occupying liver lesions in our hospital between January 2018 and September 2019, and all underwent CEUS. The imaging was classified according to LI-RADS and the diagnostic accuracy was evaluated when LR-3 or LR-4a was assumed as cut-off value. Results Out of the 60 patients, the histopathological examination showed that there were 4 cases with hepatic cysts, 16 cases with hepatic hemangioma, 8 cases with liver abscess, 9 cases with focal hepatic steatosis, 9 cases with focal hepatic hyperplasia, 8 cases with hepatocellular carcinoma and 6 cases with liver metastases; when the pathological diagnosis was set as the gold standard, the LR-3 diagnosed malignant foci in 22, and benign lesions in 38 patients, and the LR-4a diagnosed malignant in 14 patients and benign foci in 46 patients; the sensitivity, specificity and accuracy by the the former were 85.7%, 78.2% and 80.0%, and by the latter were 78.6%, 93.5%(P<0.05)and 100.0%(P<0.05). Conclusion The LR-4a of LI-RADS from CEUS could be applied to differentiate liver lesions, which have a relatively good efficacy and warrants further investigation.