Diagnostic Value Of LI-RADS Classification Of Contrast Enhanced Ultrasound Combined With Tumor Marker In Hepatocellular Carcinoma

Objective:To investigate the clinical value of contrast-enhanced liver imaging reporting and data system(LI-RADS)combined with tumor maker in the diagnosis of hepatocellular carcinoma(HCC).Methods: Retrospective analysis of contrast-enhanced ultrasound data of patients with focal liver lesions at high risk of HCC who were treated at Shengjing Hospital affiliated to China Medical University from January 2014 to December 2019.At the same time,the general data and serological test results of patients were collected.According to the 2017 version of contrast-enhanced LI-RADS classification criteria,78 lesions in 75 patients were classified.Based on histopathological diagnosis or final clinical diagnosis,calculate the sensitivity,specificity,positive predictive value,and negative predictive value of the LI-RADS contrast-enhanced ultrasound classification criteria for the diagnosis of hepatocellular carcinoma;Consistency,draw the receiver’s working characteristic curve and calculate the area under the curve.Results:Among the 78 lesions,50(64.1%),13(16.7%),and 15(19.2%)confirmed HCC,non-HCC,and benign lesions by pathology and close follow-up.LI-RADS of 78 lesions classified as LR-1,LR-2,LR-3,LR-4,LR-5,LR-M and the proportion of HCC in each classification were 3(0%),3(33.3%),2(0%),20(70%),29(82.8%),21(52.4%).Combined with hepatocellular carcinoma tumor markers and clinical follow-up,the number of lesions classified as LR-1,LR-2,LR-3,LR-4,LR-5,LR-M by LI-RADS and the percentage of HCC in each classification There are 3(0%),6(16.7%),0(0%),11(54.5%),44(86.4%),and 14(28.6%)respectively.If LR-1,LR-2,LR-3,and LR-M are classified as negative,and LR-4 and LR-5 are classified as positive,the sensitivity of diagnosis of hepatocellular carcinoma before and after combined with tumor markers is76%.,90%,specificity is 60.7%,64.3%,positive predictive value is 77.6%,81.8%,negative predictive value is 58.6%,78.3%,accuracy is 70.5%,80.8%;Kappa values are respectively 0.364,0.565.The areas under the curve are 0.684 and 0.771,respectively.Conclusion: the LI-RADS cassification of CEUS has high application value for diagnosis and differentiation of hepatocellular carcinoma(HCC),combined tumor maker with LI-RADS cassification can significantly improve the diagnostic accuracy of HCC.