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首页> 外文期刊>Journal of Clinical Ultrasound: JCU >The gross classification of hepatocellular carcinoma: Usefulness of contrast-enhanced US
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The gross classification of hepatocellular carcinoma: Usefulness of contrast-enhanced US

机译：肝细胞癌的总体分类：增强对比美国的实用性

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Background: This study investigated the usefulness of postvascular images of contrast-enhanced ultrasonography (CE-US) in the gross classification of hepatocellular carcinoma (HCC) in comparison with contrast-enhanced CT (CE-CT) findings. Methods: This is a prospective study with consecutive HCC patients who had both CE-US and CE-CT prior to surgical resection. Fifty-one patients (32 men, 19 women; mean age, 68.9 years) with 61 HCCs were enrolled. The maximal diameters of all tumors ranged from 1.0 to 5.0 cm (mean±SD, 2.5 cm±1.1). Weighted kappa statistics were used to assess the agreement of the sonographic or CT findings versus the results of macroscopic configurations. Results: Thirty-nine tumors were macroscopically diagnosed as simple nodule type; 19 tumors were macroscopically diagnosed as simple nodular type with extranodular growth, and 3 were macroscopically diagnosed as confluent multinodular type from the resected specimen. The diagnostic accuracy was 86.9% (53/61) for CE-US and 65.6% (40/61) for CE-CT. The differences in accuracy between CE-US and CE-CT were statistically significant (McNemar; p=0.007). Agreement analysis between gross classification using CE-US and final macroscopic results gave a kappa value of 0.74 (95% CI: 0.65-0.82), which was considered a good agreement. On the other hand, kappa coefficient value was 0.38 (95% CI: 0.28-0.48) between gross classification using CE-CT and final macroscopic results. Conclusions: CE-US is a more reliable tool than CE-CT to evaluate the gross type of HCC than CE-CT. Accurate gross classification using imaging is considered to be essential for the determination of the correct treatment strategy and the estimates of the patients' prognosis.
机译：背景：本研究调查了对比增强超声（CE-CT）的发现，对比超声造影（CE-US）的血管后图像在肝细胞癌（HCC）总体分类中的有用性。方法：这是一项前瞻性研究，涉及在手术切除之前同时接受CE-US和CE-CT的连续HCC患者。入选了61例HCC患者51例（男32例，女19例;平均年龄68.9岁）。所有肿瘤的最大直径为1.0至5.0 cm（平均值±SD，2.5 cm±1.1）。加权κ统计用于评估超声检查或CT检查结果与宏观检查结果的一致性。结果：宏观上诊断为三十九例肿瘤为单纯结节型。从切除的标本中宏观诊断出19例肿瘤为结节外生长的单纯结节型，宏观诊断为融合的多结节型3例。 CE-US的诊断准确性为86.9％（53/61），CE-CT的诊断准确性为65.6％（40/61）。 CE-US和CE-CT之间的准确性差异具有统计学意义（McNemar; p = 0.007）。使用CE-US进行的总体分类与最终宏观结果之间的一致性分析得出kappa值为0.74（95％CI：0.65-0.82），这被认为是一个很好的一致性。另一方面，在使用CE-CT进行的总体分类与最终的宏观结果之间，kappa系数值为0.38（95％CI：0.28-0.48）。结论：与CE-CT相比，CE-US是评估CEA总体类型的可靠工具。使用影像学进行准确的总体分类对于确定正确的治疗策略和评估患者的预后至关重要。

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