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首页> 外文期刊>European radiology >Multidetector-row computed tomography (MDCT) for the diagnosis of hepatocellular carcinoma in cirrhotic candidates for liver transplantation: prevalence of radiological vascular patterns and histological correlation with liver explants.
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Multidetector-row computed tomography (MDCT) for the diagnosis of hepatocellular carcinoma in cirrhotic candidates for liver transplantation: prevalence of radiological vascular patterns and histological correlation with liver explants.

机译：行多探测器行计算机断层扫描（MDCT）诊断肝移植肝硬化候选者的肝细胞癌：放射血管的盛行以及与肝外植体的组织学相关性。

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AIM: To define the prevalence of different multidetector-row computed tomography (MDCT) vascular patterns and their histopathological correlation with liver explants, and to evaluate the accuracy of MDCT for the diagnosis of hepatocellular carcinoma (HCC). METHODS: We retrospectively reviewed 125 cirrhotic patients imaged by MDCT before liver transplantation. Three main vascular patterns were identified: hypervascular lesion with washout (Hyper-L-Wo), hypervascular lesion without washout (Hyper-L) and non-hypervascular lesion (Hypo-L). Radiological findings were matched with histopathology of explants. RESULTS: Positive predictive value (PPV) and likelihood ratio (LR) were 95% and 18.66, respectively, for Hyper-L-Wo; 45% and 0.82 for Hyper-L; and 75% and 3 for Hypo-L of 20 mm or larger. Overall accuracy of MDCT for detection and characterisation of HCC was 89% and 43%, respectively. Sensitivity of MDCT for detection and characterisation was related to the lesion size, ranging from 78% (lesion smaller than 10 mm) to 98% (larger than 20 mm) and from 9% to 64%, respectively. MDCT established the accurate stage of disease in 46% of the patients, underestimated in 52% and overestimated in 2%. CONCLUSION: In cirrhotic patients, any Hyper-L-Wo detected by MDCT can be confidently considered to be HCC. Hyper-L larger than 10 mm and Hypo-L of 20 mm or larger are at high risk of HCC. However, even using MDCT and the newest imaging protocols, imaging underestimated the diagnosis of small HCC.
机译：目的：定义不同的多排行计算机断层扫描（MDCT）血管模式的流行及其与肝外植体的组织病理学关系，并评估MDCT诊断肝细胞癌（HCC）的准确性。方法：我们回顾性分析了肝移植前通过MDCT成像的125例肝硬化患者。确定了三种主要的血管类型：有冲刷的高血管病变（Hyper-L-Wo），无冲刷的高血管病变（Hyper-L）和非超血管病变（Hypo-L）。放射学发现与外植体的组织病理学相匹配。结果：Hyper-L-Wo的阳性预测值（PPV）和似然比（LR）分别为95％和18.66。 Hyper-L分别为45％和0.82;对于20mm或更大的Hypo-L，分别为75％和3。 MDCT检测和表征HCC的总体准确性分别为89％和43％。 MDCT检测和表征的敏感性与病变大小有关，分别为78％（小于10mm的病变）至98％（大于20mm）和9％至64％。 MDCT在46％的患者中确定了准确的疾病分期，低估了52％，高估了2％。结论：在肝硬化患者中，通过MDCT检测到的任何Hyper-L-Wo都可以肯定地认为是HCC。大于10毫米的Hyper-L和20毫米或更大的Hypo-L均具有高HCC风险。但是，即使使用MDCT和最新的影像学协议，影像学也低估了小肝癌的诊断。

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