To investigate the diagnostic concordance between CEUS LI-RADS and CT/MR LI-RADS for focal intrahepatic lesions in patients at high risk of hepatocellular carcinoma.
Methods:
Retrospective analysis of imaging data of patients at high risk of HCC attending our hospital from January 2018 to January 2021, 165 lesions were classified according to CEUS LI-RADS and CT/MR LI-RADS, respectively, using puncture biopsy or surgical pathology as the criteria. The kappa concordance test was used to evaluate the classification results of intrahepatic focal lesions in high-risk groups.
Results:
The concordance between CEUS and CT/MRI LI-RADS for the classification of intrahepatic focal lesions in the high-risk group of HCC was statistically different (P < 0.001), and the agreement between the two imaging methods was general (kappa = 0.345，P < 0.001). The positive predictive value of CEUS LR-5 for HCC was 95.4%, and the positive predictive value of CT/MRI LR-5 had a positive predictive value of 94.6% for HCC, and the difference between CEUS and CT/MRI LR-5 for HCC was not statistically significant. The positive predictive value of CEUS LR-M for non-HCC malignancies was 34.1%, and the positive predictive value of CT/MRI LR-M for non-HCC malignancies was 76.5%, and the difference between CEUS and CT/MRI LR-M had a statistically significant difference in the positive predictive value for non-HCC malignancies (P < 0.05).
Conclusions:
The classification results of CEUS and CT/MRI LI-RADS for focal intrahepatic lesions in a high-risk group of HCC were in general agreement, but both had high diagnostic performance, and both had high specificity and positive predictive value using LR-5 as the diagnostic imaging standard for HCC, while the differential diagnostic value of LR-M for non-HCC malignant tumors and HCC still needs to be further investigated.
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