PDF(Pubmed)
Abstract：
UNASSIGNED: The purpose of this study was to investigate the added value of color parameter imaging (CPI) in the differential diagnosis of focal liver lesions (FLLs) with \"homogeneous hyperenhancement but not wash out\" on contrast-enhanced ultrasound (CEUS).
UNASSIGNED: A total of 101 patients with 108 FLLs were enrolled in this study. All the FLLs received US and CEUS examinations. The stored CEUS clips of target lesions were postprocessed with CPI analysis by radiologists. The receiver operator characteristic (ROC) curve was used to evaluate the added value of CPI. The McNamara test was used to compare the diagnostic sensitivity, specificity, and accuracy between CEUS and CPI patterns. Univariate and multivariate logistic regression analyses were used to develop a CPI nomogram. The C index and calibration curve were used to evaluate the predictive ability of the nomogram. The intraclass correlation coefficient was used to test the reproducibility and reliability of CPI. Decision curve analysis (DCA) was used to evaluate the added value of applying CPI.
UNASSIGNED: The following CPI features were more frequently observed in malignant FLLs: eccentric perfusion (malignant: 70.0% vs. benign: 29.2%, p < 0.001), feeding artery (51.7% vs. 4.2%, p < 0.001), mosaic (63.3% vs. 6.3%, p < 0.001), red ingredients >1/3 (90.0% vs. 14.6%, p < 0.001). In addition, centripetal (43.8% vs. 18.3%, p = 0.004), peripheral nodular (54.2% vs. 1.7%, p < 0.001), subcapsular vessel (12.5% vs. 0.0%, p = 0.004), spoke-wheel vessels (25.0% vs. 5.0%, p = 0.003), branched vessels (22.9% vs. 5.0%, p = 0.006), blue and pink ingredients >2/3 (85.4% vs. 10.0%, p < 0.001) were more observed in benign FLLs. A nomogram incorporating peripheral nodular, spoke-wheel vessels, and red ingredients >1/3 was constructed. The model had satisfactory discrimination (AUC = 0.937), and the optimal diagnostic threshold value was 0.740 (0.983, 0.850). By the DCA, the model offered a net benefit over the treat-all-patients scheme or the treat-none scheme at a threshold probability 5%-93%.
UNASSIGNED: Using CPI can detect and render subtle information of the main features of FLLs on CEUS; it is conducive to the radiologist for imaging interpretation, and a combining read of the CEUS and CPI of the FLLs with features of \"homogenous hyperenhancement and no washout\" can improve significantly the diagnostic performance of CEUS for FLLs.
UNASSIGNED: A total of 101 patients with 108 FLLs were enrolled in this study. All the FLLs received US and CEUS examinations. The stored CEUS clips of target lesions were postprocessed with CPI analysis by radiologists. The receiver operator characteristic (ROC) curve was used to evaluate the added value of CPI. The McNamara test was used to compare the diagnostic sensitivity, specificity, and accuracy between CEUS and CPI patterns. Univariate and multivariate logistic regression analyses were used to develop a CPI nomogram. The C index and calibration curve were used to evaluate the predictive ability of the nomogram. The intraclass correlation coefficient was used to test the reproducibility and reliability of CPI. Decision curve analysis (DCA) was used to evaluate the added value of applying CPI.
UNASSIGNED: The following CPI features were more frequently observed in malignant FLLs: eccentric perfusion (malignant: 70.0% vs. benign: 29.2%, p < 0.001), feeding artery (51.7% vs. 4.2%, p < 0.001), mosaic (63.3% vs. 6.3%, p < 0.001), red ingredients >1/3 (90.0% vs. 14.6%, p < 0.001). In addition, centripetal (43.8% vs. 18.3%, p = 0.004), peripheral nodular (54.2% vs. 1.7%, p < 0.001), subcapsular vessel (12.5% vs. 0.0%, p = 0.004), spoke-wheel vessels (25.0% vs. 5.0%, p = 0.003), branched vessels (22.9% vs. 5.0%, p = 0.006), blue and pink ingredients >2/3 (85.4% vs. 10.0%, p < 0.001) were more observed in benign FLLs. A nomogram incorporating peripheral nodular, spoke-wheel vessels, and red ingredients >1/3 was constructed. The model had satisfactory discrimination (AUC = 0.937), and the optimal diagnostic threshold value was 0.740 (0.983, 0.850). By the DCA, the model offered a net benefit over the treat-all-patients scheme or the treat-none scheme at a threshold probability 5%-93%.
UNASSIGNED: Using CPI can detect and render subtle information of the main features of FLLs on CEUS; it is conducive to the radiologist for imaging interpretation, and a combining read of the CEUS and CPI of the FLLs with features of \"homogenous hyperenhancement and no washout\" can improve significantly the diagnostic performance of CEUS for FLLs.
摘要：
■本研究的目的是探讨彩色参数成像（CPI）在鉴别诊断局灶性肝脏病变（FLL）中的附加值，并在对比增强超声（CEUS）上具有“均匀超增强但不冲洗”。
■本研究共纳入101例108例FLL患者。所有FLL都接受了US和CEUS考试。放射科医生对存储的目标病变的CEUS剪辑进行了CPI分析。采用受试者操作特征(ROC)曲线评价CPI的附加值。麦克纳马拉试验用于比较诊断灵敏度，特异性，以及CEUS和CPI模式之间的准确性。使用单变量和多变量逻辑回归分析来开发CPI列线图。C指数和校准曲线用于评估列线图的预测能力。采用组内相关系数检验CPI的可重复性和可靠性。使用决策曲线分析（DCA）来评估应用CPI的附加值。
■在恶性FLL中更频繁地观察到以下CPI特征：偏心灌注（恶性：70.0％与良性：29.2%，p<0.001)，供血动脉（51.7%vs.4.2%，p<0.001)，马赛克(63.3%vs.6.3%,p<0.001)，红色成分>1/3(90.0%vs.14.6%,p<0.001)。此外,向心（43.8%与18.3%,p=0.004),周围结节（54.2%vs.1.7%,p<0.001)，包膜下血管（12.5%vs.0.0%,p=0.004),轮辐船（25.0%与5.0%，p=0.003),分支血管（22.9%与5.0%，p=0.006),蓝色和粉红色成分>2/3（85.4％vs.10.0%,p<0.001）在良性FLL中观察到更多。包含周围结节的列线图，轮辐船，红色成分>1/3被构造。该模型具有令人满意的判别(AUC=0.937)，最佳诊断阈值为0.740（0.983，0.850）。根据DCA，与所有患者治疗方案或无治疗方案相比,该模型的净获益阈值概率为5%-93%.
■使用CPI可以在CEUS上检测和渲染FLL主要特征的细微信息；有利于放射科医生进行成像解释，结合FLL的CEUS和CPI读数，具有“同质超增强和无洗脱”的特征，可以显着提高CEUS对FLL的诊断性能。
■本研究共纳入101例108例FLL患者。所有FLL都接受了US和CEUS考试。放射科医生对存储的目标病变的CEUS剪辑进行了CPI分析。采用受试者操作特征(ROC)曲线评价CPI的附加值。麦克纳马拉试验用于比较诊断灵敏度，特异性，以及CEUS和CPI模式之间的准确性。使用单变量和多变量逻辑回归分析来开发CPI列线图。C指数和校准曲线用于评估列线图的预测能力。采用组内相关系数检验CPI的可重复性和可靠性。使用决策曲线分析（DCA）来评估应用CPI的附加值。
■在恶性FLL中更频繁地观察到以下CPI特征：偏心灌注（恶性：70.0％与良性：29.2%，p<0.001)，供血动脉（51.7%vs.4.2%，p<0.001)，马赛克(63.3%vs.6.3%,p<0.001)，红色成分>1/3(90.0%vs.14.6%,p<0.001)。此外,向心（43.8%与18.3%,p=0.004),周围结节（54.2%vs.1.7%,p<0.001)，包膜下血管（12.5%vs.0.0%,p=0.004),轮辐船（25.0%与5.0%，p=0.003),分支血管（22.9%与5.0%，p=0.006),蓝色和粉红色成分>2/3（85.4％vs.10.0%,p<0.001）在良性FLL中观察到更多。包含周围结节的列线图，轮辐船，红色成分>1/3被构造。该模型具有令人满意的判别(AUC=0.937)，最佳诊断阈值为0.740（0.983，0.850）。根据DCA，与所有患者治疗方案或无治疗方案相比,该模型的净获益阈值概率为5%-93%.
■使用CPI可以在CEUS上检测和渲染FLL主要特征的细微信息；有利于放射科医生进行成像解释，结合FLL的CEUS和CPI读数，具有“同质超增强和无洗脱”的特征，可以显着提高CEUS对FLL的诊断性能。
