Contrast‐Enhanced Ultrasound for Differentiation Between Poorly Differentiated Hepatocellular Carcinoma and Intrahepatic Cholangiocarcinoma

作者：Huan‐Ling Guo, Xin Zheng, Mei‐Qing Cheng, Dan Zeng, Hui Huang, Xiaoyan Xie, Ming‐De Lu, Ming Kuang, Wei Wang, Meng‐Fei Xian, Li‐Da Chen · 发表于：Journal of Ultrasound in Medicine · 年份：2021 · DOI：10.1002/jum.15812 · 被引用次数：23 · 研究领域：Cholangiocarcinoma and Gallbladder Cancer Studies、Hepatocellular Carcinoma Treatment and Prognosis、Gallbladder and Bile Duct Disorders

PURPOSE: To evaluate the diagnostic performance of LR-5 for diagnosing poorly differentiated hepatocellular carcinoma (p-HCC). To build a contrast-enhanced ultrasound (CEUS) signature for improving the differential diagnostic performance between p-HCC and intrahepatic cholangiocarcinoma (ICC). METHODS: The B-mode ultrasound (BUS) and CEUS features of 60 p-HCCs and 56 ICCs were retrospectively analyzed. The CEUS LI-RADS category was assigned according to CEUS LI-RADS v2017. A diagnostic CEUS signature was built based on the independent significant features. An ultrasound (US) signature combining both BUS and CEUS features was also built. The diagnostic performances of the CEUS signature, US signature, and LR-5 were evaluated by receiver operating characteristic (ROC) analysis. RESULTS: One (1.7%) p-HCC and 26 (46.4%) ICC patients presented cholangiectasis or cholangiolithiasis (P < .001). Fifty-four (90.0%) p-HCCs and 8 (14.3%) ICCs showed clear boundaries in the artery phase (P < .001). The washout times of p-HCCs and ICCs were 81.0 ± 42.5 s and 34.7 ± 8.6 s, respectively (P < .001). The AUC, sensitivity, and specificity of the CEUS signature, US signature, and LR-5 were 0.955, 91.67%, and 90.57% versus 0.976, 96.67%, and 92.45% versus 0.758, 51.67%, and 100%, respectively. The AUC and sensitivity of CEUS LI-RADS were much lower than those of the CEUS and US signatures (P < .001). CONCLUSION: LR-5 had high specificity but low sensitivity in diagnosing p-HCC. When the washout ...