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Objective:To investigate the correlation of hepatocellular carcinoma (HCC) classified by contrast-enhanced ultrasound (CEUS) Liver Imaging Data and Report System (LI-RADS) with differentiation degree and Ki-67 index.Methods:A multicenter, retrospective study was conducted.The clinical and CEUS imaging data of 208 patients with 208 HCC lesions from December 2017 to December 2020 in China CEUS database were included and analyzed. According to the CEUS LI-RADS version 2017 proposed by the American College of Radiology, the HCC was classified. The diagnosis and pathological information of all lesions were confirmed by pathology. The differentiation degree of HCC and the distribution of Ki-67 index in different LI-RADS categories were evaluated, and their correlation was analyzed.Results:The degree of differentiation and Ki-67 index among HCC of different CEUS LI-RADS were statistically significant ( P<0.001, P=0.009). LI-RADS M HCC was more likely to be poorly differentiated and showed a higher Ki-67 index. The category of LI-RADS was positively correlated with the degree of tumor differentiation (tau-b=-0.250, P<0.001) and the Ki-67 index (tau-b=0.178, P=0.002), that is, the higher the category of LI-RADS, the lower differentiation degree and the higher the Ki-67. Conclusions:The CEUS LI-RADS classification of HCC is correlating with the degree of differentiation and Ki-67 index.
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Objective:To investigate the diagnostic value of the post-vascular phase of contrast-enhanced ultrasound in the differentiation of hepatocellular carcinoma (HCC).Methods:The contrast-enhanced ultrasound data of 115 patients who were admitted to Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology for liver space-occupying lesions from September 2020 to September 2021 were retrospectively analyzed. All patients underwent contrast-enhanced ultrasound with perfluorobutane microspheres for injection within 1 week before operation and were confirmed to be HCC by postoperative pathology. According to the pathological results, the lesions were divided into two groups—a well differentiated group and a poorly differentiated group. The time intensity curves of the regions of interest were drawn to obtain the quantitative parameters of arterial phase and the post-vascular phase. The diagnostic performance of each quantitative parameter in differentiating the two groups of lesions was evaluated and the cut-off value was calculated.Results:117 lesions from 115 patients were finally included in the study, including 70 lesions in the well differentiated group and 47 lesions in the poorly differentiated group. There were no significant differences in the initial growth time, peak time, rise time and the absolute value of peak intensity of lesions between the two groups in the arterial phase (all P>0.05). In the post-vascular phase(12 min), the absolute value of enhancement intensity, intensity ratio and intensity difference of the well differentiated group were lower than those in the poorly differentiated group, and the difference was statistically significant (all P<0.01). The sensitivity and specificity of the absolute value of enhancement intensity<56.117 dB, intensity ratio<1.212, intensity difference<9.184 dB to distinguish the HCC lesions as well-differentiated group were 48.9% and 80.0%, 87.2% and 77.1%, 89.4% and 75.7%, respectively. Conclusions:The quantitative analysis of the post-vascular phase of contrast-enhanced ultrasound is helpful to identify the differentiation degree of HCC and has certain clinical application value.
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Objective@#To explore the value of gadolinium-ethoxybenzyl-diethylenetriamine (Gd-EOB-DTPA) enhanced MRI T1 mapping in diagnosing and distinguishing dysplastic nodule (DN) and hepatocellular carcinoma (HCC) with different degrees of differentiation.@*Methods@#A retrospective study in the first affiliated Hospital of Guangxi Medical University from September 2015 to December 2017 was conducted. Seventy-one patients with HCC or DN (a total of 79 lesions) that confirmed by biopsy or surgical pathology findings. Seventy-nine lesions were divided into DN (n=10), well differentiated HCC (n=15), moderately differentiated HCC (n=36) and poorly differentiated HCC (n=18) according to histopathology. All the patients underwent plain MRI scan and Gd-EOB-DTPA-MRI T1 mapping before surgery or needle biopsy. The T1 values of each lesion and non-tumorous liver parenchyma were measured on 20 min hepatobiliary phase (HBP) T1 mapping after Gd-EOB-DTPA administration, respectively. The increment rate of T1 value in lesions relative to non-tumorous liver parenchyma were calculated. One-way ANOVA was used to compare the differences of T1 value and the increment rate of T1 value of DN and 3 groups of HCC with different degrees of differentiation. Spearman correlation was used to evaluate the correlation between T1 mapping parameters and the malignancy degree of DN and HCC. Area under the receiver operating characteristic (ROC) curves were used to evaluate the efficacy of T1 mapping parameters in the differential diagnosis of DN and HCC with different degree of differentiation.@*Results@#Significant differences were found in T1 value and increase rate of T1 value of DN and HCC with different degrees of differentiation (P< 0.05). The T1 value and increase rate of T1 value showed an increasing trend from DN to poorly differentiated HCC after enhancement. The T1 value and increase rate of T1 value were positively correlated with the malignancy of DN and HCC (r=0.418 and 0.634, P<0.01). There were significant differences in the increase rate of T1 value between well-differentiated HCC and moderately-differentiated, well-differentiated HCC and poorly-differentiated HCC, respectively (P<0.05). The area under ROC curve of T1 value and the increase rate of T1 value for differentiating DN from well-differentiated, moderately differentiated and poorly differentiated HCC was 0.933, 0.928, 0.939 and 0.867, 0.961, 0.961, respectively. The area under ROC curve of the increase rate of T1 value for differentiating well-differentiated HCC from moderately-differentiated, well-differentiated HCC from poorly-differentiated HCC was 0.770 and 0.844, respectively.@*Conclusions@#Gd-EOB-DTPA enhanced MRI combined with T1 mapping can provide valuable diagnostic information for identifying DN and HCC with different degrees of differentiation.