Perilesional Enhancement: A Valuable Feature for Differentiation of Hepatocellular Carcinoma and Intrahepatic Cholangiocarcinoma in CEUS LI-RADS M

IF 3.9 2区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Academic Radiology Pub Date : 2025-02-21 DOI:10.1016/j.acra.2024.12.071

Xia Meng, Ye Yun , Wei Jiang, Yu-wen Bi, Ting Dai, Zhi-Xia Sun

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Abstract

Rationale and Objectives

We investigated whether the peritumoral enhancement feature can aid in discriminating hepatocellular carcinoma (HCC) from intrahepatic cholangiocarcinoma (ICC) in contrast-enhanced ultrasound (CEUS) Liver Imaging Reporting and Data System M (LR-M).

Materials and Methods

Between May 2018 and July 2024, 147 LR-M and 320 LR-5. lesions with pathologically confirmed HCC and ICC diagnoses after CEUS were examined. We evaluated the diagnostic efficacy of HCC with different diameters (≤3, 3–5, and 5–7 cm) in the LR-M by peritumoral enhancement. We analysed the correlation between pathological perilesional hepatic sinusoid vessels and perilesional enhancement on CEUS in LR-M. The diagnostic performance of LR-5 with and without perilesional enhancement was evaluated.

Results

There were 93/107 HCC lesions and 1/40 ICC lesion with perilesional hepatic sinusoid vessels in LR-M. CEUS revealed perilesional enhancement in 81.31% (87/107) of HCC lesions and 10.00% (4/40) of ICC lesions. There was a correlation between perilesional hepatic sinusoid vessel and perilesional enhancement with correlation coefficients of 0.738. The diagnostic efficacy of 5–7 cm lesions was the best, and the sensitivity, specificity, accuracy, and AUC were 0.900, 0.864, 0.885, and 0.882. After perilesional enhancement was added to LR-5, 91 cases of HCC in LR-M were adjusted into LR-5. The adjusted diagnostic efficacy was significantly improved.

Conclusion

Perilesional enhancement on CEUS correlates with perilesional hepatic sinusoid vessel. Perilesional enhancement is a valuable feature for distinguishing HCC and ICC and could be added as a feature in CEUS LI-RADS.

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病灶周围增强：超声造影LI-RADS鉴别肝细胞癌和肝内胆管癌的重要特征。

理由和目的：我们研究了肿瘤周围增强特征是否有助于在对比增强超声（CEUS）肝脏成像报告和数据系统M （LR-M）中区分肝细胞癌（HCC）和肝内胆管癌（ICC）。材料与方法：2018年5月至2024年7月，147个LR-M和320个LR-5。超声造影后病理证实为HCC和ICC的病变进行检查。我们通过瘤周增强对不同直径（≤3,3 -5和5-7cm）的LR-M HCC的诊断效果进行了评估。我们分析了病灶周围肝窦血管病变与病灶周围超声增强的相关性。评估有无病灶周围增强的LR-5的诊断性能。结果：肝癌伴肝窦周围病变93/107，ICC伴肝窦周围病变1/40。超声造影显示81.31%（87/107）的HCC和10.00%（4/40）的ICC病变病灶周围强化。肝窦血管与病灶周围强化的相关系数为0.738。5-7cm病变的诊断效果最好，敏感性、特异性、准确性和AUC分别为0.900、0.864、0.885和0.882。在LR-5基础上增加病灶周围强化后，91例LR-M HCC调整为LR-5。调整后的诊断效能显著提高。结论：超声造影病灶周围增强与病灶周围肝窦血管相关。病灶周围增强是区分HCC和ICC的一个有价值的特征，可以作为超声造影LI-RADS的一个特征。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Academic Radiology 医学-核医学

CiteScore

7.60

自引率

10.40%

发文量

432

审稿时长

18 days

期刊介绍： Academic Radiology publishes original reports of clinical and laboratory investigations in diagnostic imaging, the diagnostic use of radioactive isotopes, computed tomography, positron emission tomography, magnetic resonance imaging, ultrasound, digital subtraction angiography, image-guided interventions and related techniques. It also includes brief technical reports describing original observations, techniques, and instrumental developments; state-of-the-art reports on clinical issues, new technology and other topics of current medical importance; meta-analyses; scientific studies and opinions on radiologic education; and letters to the Editor.