Dan Yang1, Hong Hu2, Rui Li3, Chun-Lin Tang4, Kuan-Sheng Ma5, De-Yu Guo6. 1. Department of Ultrasound, The Third Affiliated Hospital of Chongqing Medical University, Shuanghu branch road, Yubei, Chongqing, 401120, China. 2. Department of Ultrasound, Chongqing Jiangbei Hospital of Traditional Chinese Medicine, Jiangbei, Chongqing, China. 3. Department of Ultrasound, The Third Affiliated Hospital of Chongqing Medical University, Shuanghu branch road, Yubei, Chongqing, 401120, China. raylee7991@163.com. 4. Department of Ultrasound, Southwest Hospital Affiliated to Army Medical University, Shapingba, Chongqing, China. 5. Department of Hepato-Biliary-Pancreatic Surgery, Southwest Hospital Affiliated to Army Medical University, Shapingba, Chongqing, China. 6. Department of Pathology, Southwest Hospital Affiliated to Army Medical University, Shapingba, Chongqing , China.
Abstract
PURPOSE: To explore the diagnostic value of American College of Radiology Contrast-Enhanced Ultrasound-Liver Imaging Reporting and Data System (ACR-CEUS-LI-RADS) for hepatocellular carcinoma (HCC) in patients with cirrhosis and chronic hepatitis B. METHODS: A total of 205 patients at high risk of HCC with solitary hepatic nodule were enrolled and retrospectively analyzed. All patients were over 18 years old and had a single lesion with a diameter < 50 mm. Lesions were categorized according to size and contrast enhancement patterns in the arterial, portal venous and late phases. Diagnostic efficacy of CEUS LI-RADS for HCC, and the rate of non-HCC malignancies in the LR-M class were compared between patients with cirrhosis and chronic hepatitis B. RESULTS: Of all 205 nodules (median nodule size was 34 mm), 142 (69.3%) were HCC. Of the 127 (61.9%) LR-5 category nodules, 95.8% (92/96) nodules were corresponded to HCC in cirrhosis, while 61.3% (19/31) nodules were corresponded to HCC in chronic hepatitis B (P = 0.000). Positive predictive value (PPV) of LR-5 category for HCC was 95.8% in cirrhosis and 61.3% in chronic hepatitis B (P = 0.000). More category of LR-4 nodules were proved to be HCC in patients with cirrhosis than chronic hepatitis B (80.0% vs 8.3%, P = 0.000). Of 41 LR-M category nodules, more non-HCC malignancies were found in chronic hepatitis B (76.0%) than that in cirrhosis (25.0%, P = 0.001). CONCLUSIONS: The LR-5 category is highly specific for the diagnosis of HCC in patients with cirrhosis. However, LR-5 category nodules require further CT or MRI examination or histological confirmation in patients with chronic hepatitis B for its unsatisfactory PPV for HCC.
PURPOSE: To explore the diagnostic value of American College of Radiology Contrast-Enhanced Ultrasound-Liver Imaging Reporting and Data System (ACR-CEUS-LI-RADS) for hepatocellular carcinoma (HCC) in patients with cirrhosis and chronic hepatitis B. METHODS: A total of 205 patients at high risk of HCC with solitary hepatic nodule were enrolled and retrospectively analyzed. All patients were over 18 years old and had a single lesion with a diameter < 50 mm. Lesions were categorized according to size and contrast enhancement patterns in the arterial, portal venous and late phases. Diagnostic efficacy of CEUS LI-RADS for HCC, and the rate of non-HCC malignancies in the LR-M class were compared between patients with cirrhosis and chronic hepatitis B. RESULTS: Of all 205 nodules (median nodule size was 34 mm), 142 (69.3%) were HCC. Of the 127 (61.9%) LR-5 category nodules, 95.8% (92/96) nodules were corresponded to HCC in cirrhosis, while 61.3% (19/31) nodules were corresponded to HCC in chronic hepatitis B (P = 0.000). Positive predictive value (PPV) of LR-5 category for HCC was 95.8% in cirrhosis and 61.3% in chronic hepatitis B (P = 0.000). More category of LR-4 nodules were proved to be HCC in patients with cirrhosis than chronic hepatitis B (80.0% vs 8.3%, P = 0.000). Of 41 LR-M category nodules, more non-HCC malignancies were found in chronic hepatitis B (76.0%) than that in cirrhosis (25.0%, P = 0.001). CONCLUSIONS: The LR-5 category is highly specific for the diagnosis of HCC in patients with cirrhosis. However, LR-5 category nodules require further CT or MRI examination or histological confirmation in patients with chronic hepatitis B for its unsatisfactory PPV for HCC.
Authors: M Claudon; C F Dietrich; B I Choi; D O Cosgrove; M Kudo; C P Nolsøe; F Piscaglia; S R Wilson; R G Barr; M C Chammas; N G Chaubal; M-H Chen; D A Clevert; J M Correas; H Ding; F Forsberg; J B Fowlkes; R N Gibson; B B Goldberg; N Lassau; E L S Leen; R F Mattrey; F Moriyasu; L Solbiati; H-P Weskott; H-X Xu Journal: Ultraschall Med Date: 2012-11-05 Impact factor: 6.548